Farmer's lung—a 5‐year follow‐up of eighty‐six patients

Abstract

Summary We studied the clinical course of eighty‐six patients with fanner's lung for a period of 5 years. The patients were first evaluated at an acute or sub‐acute stage of the disease and 1, 3, 6, 12 and 60 months thereafter. Special attention was paid to the development of lung function and radiological findings with reference to corticosteroid treatment and antigen contact during the follow‐up. Many of the patients were severely ill at the acute stage of the disease. Most of the recovery took place during the first month. Significant improvement of lung function happened up to 6 months, thereafter the improvement was insignificant. After 5 years, respiratory symptoms were reported by 65% and minor respiratory dysfunction (lowered diffusing capacity) was observed in about 40% of the farmers. Thirty‐two per cent of the patients showed diffuse opacities in chest X‐ray. Corticosteroid treatment had no effect on long term prognosis. There was no difference in the recovery of lung function between those who returned to work compared with those who did not. Exacerbations happened in 8% of the patients during the follow‐up. We conclude that respiratory symptoms, minor airway dysfunction and mild radiological fibrosis are common findings after 5 years of an acute or sub‐acute stage of the farmer's lung. However, in Finland two‐thirds of the patients return back to their previous occupation of farming and cattle feeding.

Asthma in patients with farmer's lung during a five-year follow-up

“…The proportion of smokers among farmer's lung patients is low (3,7,12). The mean age and gender distribution of farmer's lung patients in this study were close to those of 2 other Finnish follow-up studies (3,7).…”

Hypersensitivity pneumonitis

“…These will help control symptoms of acute or subacute bouts of the disease but do not seem to help the long-term outcome (153). When contact can be avoided there is no need for any medication unless the attack is extremely severe compromising ventilation or gas exchange.…”

Hypersensitivity pneumonia: the role of lung biopsy in diagnosis and management

“…25 Corticosteroids are useful in accelerating the rate of recovery, but do not affect the long-term outcome, independent of eliminating antigenic exposure. 26,27 Lung function improves over a period of months and years, but abnormalities may persist in nearly half of patients. [26][27][28] Diseasespecific mortality rates in chronic hypersensitivity pneumonia range from 10 to nearly 30%.…”