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VOLUME 12 , ISSUE 4 ( October-December, 2023 ) > List of Articles

Original Article

Hypersensitivity Pneumonitis with Environmental Exposure Manifesting as Fibrotic and Nonfibrotic Forms at a Tertiary Care Center in Western Maharashtra

Ajai Kumar Tentu, Samruddhi P Deshpande, Nilesh P Phole, Rongala Laxmivandana

Keywords : Avian droppings, Bronchoalveolar lavage, Exposure history, Forced vital capacity, High-resolution computerized tomography

Citation Information : Tentu AK, Deshpande SP, Phole NP, Laxmivandana R. Hypersensitivity Pneumonitis with Environmental Exposure Manifesting as Fibrotic and Nonfibrotic Forms at a Tertiary Care Center in Western Maharashtra. Indian J Respir Care 2023; 12 (4):345-351.

DOI: 10.5005/jp-journals-11010-1077

License: CC BY-NC-SA 4.0

Published Online: 18-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Aims and background: Hypersensitivity pneumonitis (HP) is a complex immune-mediated disease affecting the lung, leading to fibrosis on recurrent exposure to organic/inorganic antigens. The sources of antigens include avian droppings, avian feathers, cotton fibers, metal particles, chemical fumes, etc. Materials and methods: This study comprises 27 adult individuals presenting with HP symptoms like shortness of breath, cough, chest tightness, fatigue, and wheezing who were assessed for clinical, radiological, functional, and bronchoscopic alveolar lavage evaluation. Results: The mean age of 27 patients diagnosed with HP in our study is 67.4 years which comprises 11 males and 16 females. Out of 27 (92.6%), 25 patients had prior comorbidities, of which hypertension (HTN) (44.4%) and type 2 diabetes mellitus (33.3%) were major contributors. Among 27 patients, 55.56% were diagnosed with fibrotic HP and 44.44% with nonfibrotic HP. The average percent predicted forced vital capacity (FVC) of patients was 61.9. The most common high-resolution computerized tomography (HRCT) chest abnormalities were ground glass opacities (GGOs) (27%). In this study, four out of 12 patients reported positive for the HP panel test. The p-value of 0.031 established a statistically significant association between type of HP and history of avian exposure in patients. Conclusion: The prevalence of HP was found to be in patients of older age, and the association of avian exposure in patients has a statistical significance in determining the type of HP. Clinical significance: This study emphasizes the importance of identifying antigen sources related to disease prognosis among HP patients.

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