Korean J Asthma Allergy Clin Immunol.  2008 Sep;28(3):226-230.

A Case of Stored Hay-induced Hypersensitivity Pneumonitis Diagnosed with Inhalational Provocation Tests Using Antigen Sources

Abstract

Hypersensitivity pneumonitis (HP) is an immunologically mediated disease which is developed by repeated exposure to sensitizing agents, such as organic dusts or chemicals. The majority of cases occur in the occupational or agricultural setting. We report a case of HP caused by stored hay for feeding cows. A 47-year-old woman has suffered from repeated episodes of cough and dyspnea accompanied by flu-like symptoms, which developed or worsened during feeding cows. Provocation tests with stored hay dusts revealed decreased FEV1 and FVC, blood leukocytosis and lymphocytosis in bronchoalveolar lavage fluid with decreased CD4+/CD8+ ratio. This case suggests that provocation tests with the antigen sources would be valuable when the diagnosis is unclear or when clinical data are insufficient.

MeSH Terms

Alveolitis, Extrinsic Allergic
Bronchial Provocation Tests
Bronchoalveolar Lavage Fluid
Cough
Dust
Dyspnea
Female
Humans
Hypersensitivity
Leukocytosis
Lymphocytosis
Middle Aged
Pneumonia
Dust