Hypersensitivity Pneumonitis Caused by Esparto Dust in a Young Plaster Worker:A Case R eport and Review of the Literature

Flandes, J.; Heili, Sarah; Seco, Julio Gómez; Sabillón, Oscar; Fernández, Itziar; Ortega, A. García

doi:10.1159/000079651

Cited by 6 publications

(3 citation statements)

References 2 publications

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“…An extrapulmonary presentation may be a challenge to the differential diagnosis [11,19,20,21,22]. In our series, an early diagnosis was reached only in 38 patients.…”

Section: Introductionmentioning

confidence: 61%

Unusual Presentation of Sarcoidosis

Rizzato

Tinelli

2005

Respiration

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The extrapulmonary presentation of sarcoidosis is a frequent occurrence – over 30% of cases when the observation is prospective – but early diagnosis may still be a challenge. A comparison between two different Italian series – (1) patients visiting the Milan Sarcoidosis Clinic of an Internal Medicine Department and (2) an Italian Register from many pneumology centers (RIPID) – has shown a different approach to the diagnosis because pneumologists are more likely to use transbronchial biopsy, while internists are more likely to use extrapulmonary biopsies. Such a different clinical approach may be due in part to a different case mix of the two series.

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“…An extrapulmonary presentation may be a challenge to the differential diagnosis [11,19,20,21,22]. In our series, an early diagnosis was reached only in 38 patients.…”

Section: Introductionmentioning

confidence: 61%

Unusual Presentation of Sarcoidosis

Rizzato

Tinelli

2005

Respiration

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“…7 Today, there are more than 200 different antigens underlying HP, consisting of products of plant or animal origin, aerosolized microorganisms, and organic chemicals that must have a diameter below 3 to 5 mm to be inhaled and reach the lung periphery. 8 The most frequent antigens are listed in Table 1 and are related to a variety of distinct occupations in different places of the world, from plaster workers exposed to esparto dust in the southeast Iberian Peninsula 9 to people working in the mushroom crops of Bunashimeji in Japan. 10 The prevalence of HP is related to several factors, such as the type, intensity, and duration of exposure; the antigen concentration and solubility; particle size; and host susceptibility.…”

mentioning

confidence: 99%

Bronchoalveolar Lavage in Occupational Lung Diseases

Cordeiro

Jones²,

Alfaro³

et al. 2007

Semin Respir Crit Care Med

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Occupational lung diseases (OLDs) are related to the exposure and inhalation of organic, inorganic, and synthetic particles, fumes, gases, or infectious agents. From the long list of OLDs this article focuses the discussion on bronchoalveolar lavage (BAL) in parenchymal immunoinflammatory conditions, such as hypersensitivity pneumonitis (HP) and pneumoconiosis.Several antigens may cause HP, including products of plant or animal origin, aerosolized microorganisms, and organic chemicals. BAL is used not only to assess the pathogenesis of these diseases but also to identify the typical pattern of intense lymphocytic alveolitis, usually with a CD4:CD8 ratio below normal and frequently with the presence of mast cells, plasma cells, and foamy macrophages.Pneumoconioses are chronic interstitial lung diseases caused by the inhalation of mineral and metallic inorganic particles/dusts in an occupational setting, showing a decreasing prevalence in recent years.BAL is a useful tool not only to express the complex pathogenic mechanisms of these entities but also in excluding other diagnoses and causes of alveolitis, and to document specific exposures, such as the identification of asbestos bodies (ABs) in asbestosis or the proliferative response of BAL lymphocytes to beryllium in chronic beryllium disease (CBD).

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“…In the past years, several cases of occupational respiratory pathology caused by esparto inhalation have been reported, mainly referred to as hypersensitivity pneumonitis (HP). [1][2][3][4][5] Recently, the first case of asthma caused by esparto was described, the causative agent being a contaminant fungus, Aspergillus fumigatus. 6 We report a new case of occupational asthma by inhalation of esparto dust, caused by allergens of the plant itself and by other fungi contaminant agents.…”

mentioning

confidence: 99%

Occupational asthma due to esparto hypersensitivity in a building worker

Ruiz-Hornillos

Fernández²,

Molina³

et al. 2007

allergy asthma proc

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Esparto is a gramineous plant that has multiple applications in today's industry. Several cases of hypersensitivity pneumonitis (HP) caused by esparto inhalation have been reported, but only one case of asthma caused by Aspergillus fumigatus contaminating esparto has been communicated. We report a case of asthma induced by esparto inhalation in a 58-year-old man, who is a building industry worker, with subclinical sensitization to grass pollen. The relation between clinical symptoms and work activities was supported by peak expiratory flow (PEF) monitorization; PEF values decreased by 20% the days he handled esparto. Prick test with esparto was positive. Immunoblot analysis revealed several allergens in the esparto extract, some of them present in Lolium and A. fumigatus extracts. IgE immunoblot inhibition revealed a complete inhibition of lolium and A. fumigatus IgE reactive bands by esparto proteins. The patient then avoided the exposure to esparto at work and has remained asymptomatic for the last 2 years. In conclusion, this is a case of occupational asthma caused by esparto dust mediated by IgE antibodies. Proteins of A. fumigatus as well as proteins from this gramineous plant, which cross-reacted with esparto allergens, were responsible for the disease.

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Hypersensitivity Pneumonitis Caused by Esparto Dust in a Young Plaster Worker:A Case R eport and Review of the Literature

Cited by 6 publications

References 2 publications

Unusual Presentation of Sarcoidosis

Unusual Presentation of Sarcoidosis

Bronchoalveolar Lavage in Occupational Lung Diseases

Occupational asthma due to esparto hypersensitivity in a building worker

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