An autopsy case of bird-related chronic hypersensitivity pneumonitis presenting with repeated acute exacerbation. (2018)

• Record Type: Journal Article
• Authors: Mikumo, Hironori; Yanagihara, Toyoshi; Hamada, Naoki; Hashisako, Mikiko; Ijichi, Kayo; Suzuki, Kunihiro; Harada, Eiji; Shikada, Yasunori; Oda, Yoshinao; Nakanishi, Yoichi
• Is Part Of: Respiratory medicine case reports. Volume 24(2018)
• Page Start: 92
• Page End: 94
• Publication Date: 2018
• Subjects: Acute exacerbation -- Autopsy -- Bird-related chronic hypersensitivity pneumonitis -- Interstitial pneumonia -- Pigeon dropping extracts; NSIP Nonspecific interstitial pneumonia -- VATS video-assisted thoracoscopic surgery -- UIP usual interstitial pneumonia -- BRCHP bird-related chronic hypersensitivity pneumonitis -- HP hypersensitivity pneumonitis -- SP-D surfactant protein D -- TBLB transbronchial lung biopsy -- PDE pigeon dropping extract; Respiratory organs -- Diseases -- Periodicals; Chest -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory System -- Periodicals; Chest -- Diseases; Respiratory organs -- Diseases; Electronic journals; Periodicals; 616.2
• DOI: 10.1016/j.rmcr.2018.04.016
• Languages: English
• ISSNs: 2213-0071

Abstract

Abstract: A 68-year-old woman was admitted to our hospital with a dry cough in 2010. Chest computed tomography showed the appearance of a nonspecific interstitial pneumonia (NSIP) pattern. Video-assisted thoracoscopic surgery (VATS) was performed, and the specimens prominently showed a usual interstitial pneumonia (UIP) pattern. She was diagnosed with bird-related chronic hypersensitivity pneumonitis (BRCHP) on the basis of the detection of antibodies to pigeon dropping extract in her serum and a history of using feather-filled duvets and indirect exposure to birds in her living environment. Even though she was treated with corticosteroids and immunosuppressants and recommended to avoid bird-related antigens, she had a progressive course with repeated acute exacerbation episodes and died of respiratory failure. The autopsy findings showed diffuse alveolar damage superimposed on UIP. Clinicians should be aware that BRCHP patients especially with histopathologically UIP pattern may experience acute exacerbation.