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Rare imaging findings of hypersensitivity pneumonitis:A case report

World Journal of Clinical Cases 2020年第20期8卷 5057-5061页

作者： Hong-Juan Wang Xiao-Jun Chen Lin-Xia Fan Qiao-Ling Qi Qi-Zhang Chen Department of Respiratory Medicine Gansu Provincial People's HospitalLanzhou 730000Gansu ProvinceChina Department of Respiratory Medicine The First People's Hospital of Zhenyuan CountyLanzhou 730000Gansu ProvinceChina

BACKGROUND hypersensitivity pneumonitis(HP)is an immune-mediated syndrome caused by allergen ***-resolution computed tomography(HRCT)of HP may show diffuse ground-glass opacity,centrilobular ground-glass nodules,areas of air-trapping,thin-walled cysts,or fibrotic *** SUMMARY A 47-year-old male patient went to the hospital complaining of cough and gradual aggravation of shortness of *** of the lung showed that multiple nodules and ground-glass high-density shadows were present in both *** addition,circular high-density shadows of various sizes were widely distributed in both lungs with relatively normal lung markings inside *** other tests did not have a positive finding that can clarify the ***,the patient underwent a lung *** pathological results showed that the lesions tended to be *** 4 mo of follow-up,the lesions in the patient's lungs were absorbed spontaneously,and the symptoms of cough and shortness of breath have *** review results suggested that the patient's disease was self-healing,which was consistent with the characteristics of *** For some patients with HP,abnormal HRCT findings,such as the lesions in the lungs,can be absorbed on their own,which is an important clue in the diagnosis of the *** diagnosis by lung biopsy is necessary when antigen exposure is unknown.

关键词： hypersensitivity pneumonitis High-resolution computed tomography Self-healing Circular high-density images Case report

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Clinical characteristics of hypersensitivity pneumonitis:non-fibrotic and fibrotic subtypes

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Chinese Medical Journal 2023年第23期136卷 2839-2846页

作者： Xueying Chen Xiaoyan Yang Yanhong Ren Bingbing Xie Sheng Xie Ling Zhao Shiyao Wang Jing Geng Dingyuan Jiang Sa Luo Jiarui He Shi Shu Yinan Hu Lili Zhu Zhen Li Xinran Zhang Min Liu Huaping Dai Department of Pulmonary and Critical Care Medicine Center of Respiratory MedicineChina-Japan Friendship HospitalNational Center for Respiratory MedicineNational Clinical Research Center for Respiratory DiseasesInstitute of Respiratory MedicineChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100029China Department of Pulmonary and Critical Care Medicine Center of Respiratory MedicineChina-Japan Friendship HospitalCapital Medical UniversityBeijing 100029China Department of Radiology China-Japan Friendship HospitalBeijing 100029China Department of Pathology China-Japan Friendship HospitalBeijing 100029China Institute of Clinical Medical Sciences Center of Respiratory MedicineChina-Japan Friendship HospitalBeijing 100029China

Background:The presence of fibrosis is a criterion for subtype classification in the newly updated hypersensitivity pneumonitis(HP)*** present study aimed to summarize differences in clinical characteristics and prognosis of non-fibrotic hypersensitivity pneumonitis(NFHP)and fibrotic hypersensitivity pneumonitis(FHP)and explore factors associated with the presence of ***:In this prospective cohort study,patients diagnosed with HP through a multidisciplinary discussion were *** data included demographic and clinical characteristics,laboratory findings,and radiologic and histopathological *** regression analyses were performed to explore factors related to the presence of ***:A total of 202 patients with HP were enrolled,including 87(43.1%)NFHP patients and 115(56.9%)FHP *** with FHP were older and more frequently presented with dyspnea,crackles,and digital clubbing than patients with *** levels of carcinoembryonic antigen,carbohydrate antigen 125,carbohydrate antigen 153,gastrin-releasing peptide precursor,squamous cell carcinoma antigen,and antigen cytokeratin 21-1,and count of bronchoalveolar lavage(BAL)eosinophils were higher in the FHP group than in the NFHP *** lymphocytosis was present in both groups,but less pronounced in the FHP *** regression analyses revealed that older age,<20%of lymphocyte in BAL,and≥1.75%of eosinophil in BAL were risk factors for the development of *** patients developed adverse outcomes,with a median survival time of 12.5 months,all of whom had ***:Older age,<20%of lymphocyte in BAL,and≥1.75%of eosinophil in BAL were risk factors associated with the development of *** of patients with NFHP was better than that of patients with *** results may provide insights into the mechanisms of fibrosis in HP.

关键词： Interstitial lung disease hypersensitivity pneumonitis Clinical characteristics Fibrosis Prognosis

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The Beneficial Effect of 3-Month-Induction Therapy with Corticosteroids and Mycophenolate Mofetil Followed by Maintenance Therapy with Yearly Rituximab Infusions as Sole Maintenance Therapy in Cryptogenic Chronic hypersensitivity pneumonitis

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International Journal of Clinical Medicine 2023年第8期11卷 338-346页

作者： Kamel El-Reshaid Abdulmohsen Al-Bader Sana S. Almutairi Sayed H. M. Mohamad Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Otolaryngeology Farwania Hospital Ministry of Health Kuwait City Kuwait Department of Medicine Respiratory Unit Amiri Hospital Ministry of Health Kuwait City Kuwait Department of Radiology Al Salam Hospital Kuwait City Kuwait

Background: The available data on cryptogenic chronic hypersensitivity pneumonitis (ccHP) indicate an inherited predisposition to disease with triggering autoimmune phenomena. Hence, we evaluated prospectively the role of a new autoimmune regimen in treatment of its severe and progressive disease. Patients and Methods: A total of 9 patients were included in the study. They had criteria for ccHP viz. 1) clinical features of cryptogenic progressive restrictive lung disease, 2) high-resolution computed tomographic pulmonary abnormalities, and 3) bronchoalveolar lavage lymphocytosis (>30%). The regimen consisted of an initial induction phase of 3-month Solumedrol 1 g IV daily for 3 days followed by 1 month of Prednisone (P) 60 mg/day to tapered down to discontinuation by 3rd month. They also had received Mycophenolate mofetil (MMF) 1 g twice daily for 3 months. This stage was followed by a maintenance phase of yearly Rituximab infusions (1 g followed by 1 g 2 weeks later). Results: compared to their previous 6 months deterioration;all patients showed significant improvement in their forced vital volume, diffusion capacity for carbon monoxide, 6-minutes-walk after the induction phase (at 3 months) which improved further at 15 months with Rituximab therapy. Conclusion: After 3-month induction therapy with P and MMF;yearly R treatment is a safe, practical and effective long-term therapy for ccHP.

关键词： hypersensitivity pneumonitis Mycophenolate Mofetil Rituximab Spirometry HRCT BAL

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