Hypersensitivity Pneumonitis Flashcards
HP caused by thermophilic actinomycetes found in sugar cane
Bagassosis
Most common types (3) of hypersensitivity pneumonitis in the US
Farmer’s lung, bird fancier’s lung, and chemical worker’s lung
Antigen responsible for cheese washer’s lung
Penicillium casei
Antigen responsible for chemical worker’s lung
Isocyanates
Antigen responsible for detergent worker’s disease and familial HP
Bacillus subtilis
Two genera of thermophilic actinomycetes responsible for HP
Micropolyspora and Thermoactinomyces
Antigens (2) responsible for hot tub lung
Cladosporium spp. and Mycobacterium avium complex
Antigen responsible for Japanese-summer type HP
Trichosporon spp.
Antigens responsible for metalworking fluid lung
Mycobacterium spp. and Pseudomonas spp.
Antigen found in infested wheat flour responsible for miller’s lung
Sitophilus granarius
HP caused by Penicillium glabrum and Chrysonilia sitophila from cork dust
Suberosis
Antigen responsible for winegrower’s lung
Botrytis cinerea
Antiretroviral drug associated with HP
Efavirenz
Antituberculous medication associated with HP
Isoniazid
In HP, increase in these cells in lavage fluid has been associated with lung fibrosis
Polymorphonuclear leukocytes
Clinical manifestation of HP with the greatest predictive value for mortality
Pulmonary fibrosis
This part of the lung is commonly spared in HP
Apex
Procedure of choice for imaging in HP
High-resolution chest CT
Triad of subacute HP on lung biopsy
Mononuclear bronchiolitis, interstitial infiltrates of lymphocytes and plasma cells, and single, nonnecrotizing, randomly scattered parenchymal granulomas without mural vascular involvement
Transient fever and muscle aches, with or without dyspnea and cough; absent serum precipitins, normal chest x-ray; associated with heavy exposure to organic dusts
Organic dust toxic syndrome
Fever, chills, cough and pulmonary infiltrates within a few hours of exposure to moldy silage; absent precipitins
Pulmonary mycotoxicosis
Pattern of bronchiectasis in ABPA
Central
Main diagnostic criteria for ABPA (6)
(1) Bronchial asthma, (2) central bronchiectasis, (3) peripheral eosinophilia (more than 1000/uL), (4) immediate wheal-and-flare to A. fumigatus, (5) pulmonary infiltrates, (3) elevated serum IgE, (6) serum precipitins to A. fumigatus
(BCPIPES)
Most common cause of ABPA
Aspergillus fumigatus
Tropical eosinophilia is usually caused by infection with these organisms
Filaria
Most common cause of eosinophilic pulmonary infiltrates in the US
Drug-induced eosinophilic pneumonias
Benign, acute eosinophilic pneumonia of unknown cause characterized by migrating pulmonary infiltrates and minimal clinical manifestations; may be secondary to drugs or parasites
Loeffler’s syndrome
BAL fluid finding in acute eosinophilic pneumonia
Greater than 25% eosinophils
Normal eosinophil (%) in BAL fluid in nonsmokers
Less than 2%
Level of eosinophilia and duration in hypereosinophilic syndrome
More than 1500 eosinophils/uL for 6 months or longer
Heart valve commonly involved in hypereosinophilic syndrome
Tricuspid valve
Surgery associated with hypereosinophilic syndrome
Lung/bone marrow transplantation
Malignancy associated with hypereosinophilic syndrome
T cell lymphoma
Internationally, this is the most common form of HP
Bird breeder’s lung
Most common cause of pediatric HP
Bird breeder’s lung
Most common cause of pulmonary infiltrates with eosinophila worldwide
Parasitic infestation
