Skin testing in farmers' lung disease

Freedman, Peter M.; Ault, Barbara J.; Zeiss, C. Raymond; Treuhaft, Mary W.; Roberts, Ronald C.; Emanuel, Dean A.; Baldauf, M.C.; Marx, James J.

doi:10.1016/0091-6749(81)90045-2

Cited by 9 publications

(5 citation statements)

References 29 publications

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“…The existence of type III hypersensitivity reaction may be confirmed by 6-hr skin tests 14 ) . A positive 6-hr late skin reaction was observed in 13 (56.5%) cases in this study, and late reaction was observed in 11 (68.8%) out of 16 precipitin positive reactors.…”

Section: Discussionmentioning

confidence: 96%

“…Pepys and Jenkins obtained positive reactions in 91% of the patients with farmer’s lung by the double-diffusion test and in 89% in the immunoelectrophoretic test 13 ) . Freedman et al detected precipitating antibody in 61.3% of the patients with farmer’s lung 14 ) , and ELISA detected antibodies in 77.4% of the cases. Our result, that precipitating antibody was positive in 69.9% by CIEP ( Table 3 ), is similar to that of Freedman et al but slightly lower than that of Pepys and Jenkins.…”

Section: Discussionmentioning

confidence: 99%

“…Our result, that precipitating antibody was positive in 69.9% by CIEP ( Table 3 ), is similar to that of Freedman et al but slightly lower than that of Pepys and Jenkins. Approximately 8% to 10% of healthy farmers have circulating antibodies to antigens of causative organisms of farmer’s lung 14 ) . So it might be possible that some of them in our study had nonspecific or irritant-induced respiratory symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Type 3 Hypersensitivity Reaction in Mushroom Growers

Choi

Min

Kim

et al. 1991

Korean J Intern Med

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Some respiratory symptoms in mushroom growers such as mushroom worker’s lung develop by inhalation of certain agents arising from the environment of mushroom cultivation. Recently we observed mushroom workers who had respiratory symptoms which might be type III hypersensitivity reaction to the antigen of Pleurotus floridae.We gave questionaires to all the mushroom growers at one of the biggest cultivation areas of mushrooms, Pleurotus floridae in Pocheon, Kyunggi Province. Those with respiratory symptoms were subjects for the study. CBC, chest X-ray, pulmonary function test, skin test with Pleurotus floridae extract, and precipitin antibody test to Pleurotus floridae were performed in the study subjects.Out of a total 308 mushroom workers, 23 workers (14 males, 9 females) had respiratory symptoms. Their mean age was 45 years, and their mean duration of engagement was 3.4 years. Their main symptoms were cough (100%), sputum (82.6%), dyspnea (43.5%), and fever with chills (13.0%). Two cases showed increased interstitial lung markings on chest X-ray films. Sixteen cases (73.9%) showed precipitin antibodies against P. floridae extract by counterimmunoelectrophoresis. Antibodies against Micropolyspora faeni and Thermoactinomyces vulgaris were not detected in any subject.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Type 3 Hypersensitivity Reaction in Mushroom Growers

Choi

Min

Kim

et al. 1991

Korean J Intern Med

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“…Another study, by Morell et al found 15 of 18 patients with FL to have positive immediate intradermal skin tests with hay extract, while only 7 of 85 asymptomatic farmers had positive intradermal skin tests [115]. However, another study by Freedman et al found that 75% of patients with farmer's lung disease and 79% of well farmers with Micropolyspora faeni antibody had 2+ or greater intradermal immediate reactions to Micropolyspora faeni antigen [117]. In a pediatric study, 12 of 15 children with pigeon breeder's disease and 5 of 15 children with similar exposure history demonstrated positive immediate skin test reactions [116].…”

Section: Laboratory Evaluationmentioning

confidence: 90%

“…There have been conflicting studies regarding the usefulness of skin testing in HP [2,4,5,28,112,[114][115][116][117][118][119][120]. In a study by Morell et al in bird breeder's disease, intradermal skin testing was positive for an immediate reaction in 18 of 20 symptomatic bird breeders to diluted bird serum and in 19 of 21 symptomatic bird breeders to bird fecal extract [114].…”

Section: Laboratory Evaluationmentioning

confidence: 97%

Hypersensitivity Pneumonitis

Temprano¹,

Knutsen²,

Slavin³

2005

CPR

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Hypersensitivity pneumonitis (extrinsic allergic alveolitis) is an immunological mediated hypersensitivity reaction to a variety of inhaled allergens that may cause an acute and subacute interstitial pneumonitis and may lead to a chronic end-stage lung disease. Though more common in adults, hypersensitivity pneumonitis needs to be considered in the differential diagnosis of interstitial pneumonitis in children. In children, the most common antigens are from residential exposure to birds, humidifiers and indoor molds. Clinical features are dependent upon stage of disease, and can include fevers, chills, cough, dyspnea, fatigue and weight loss. Physical examination often reveals rales, and dyspnea and hypoxemia are usually present. Routine laboratory testing demonstrates a moderately elevated erythrocyte sedimentation rate, leukocyte count, total IgG level and a positive rheumatoid factor. Though serum IgG antibodies are elevated to the inhaled antigen(s) in hypersensitivity pneumonitis, they may be present in asymptomatic exposed individuals. The immunopathogenesis involves cellular immunity to inhaled allergens, especially CD8+ cytotoxic T cells, multinucleated giant cells, and ultimately granulomas. The role of antigen-specific IgG antibodies is unclear, but may be involved in antibody-dependent-cellular-cytotoxicity (ADCC) and/or interaction with FcRγ on dendritic cells and monocytes that enhance a Th1 response. Pulmonary function studies demonstrate a restrictive pattern with a diffusion defect resulting in hypoxemia. Radiographic changes vary according to the stage of the disease and are best evaluated by high resolution computerized tomography. Bronchoalveolar lavage demonstrates a lymphocytosis with characteristic increase of CD8+ T cells and NK cells. However, recent literature suggests that the CD4+/CD8+ ratio may not be decreased in children as found in adults. Treatment of hypersensitivity pneumonitis is antigen avoidance and systemic corticosteroids, and prognosis depends on early recognition of the disease.

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Bio-Aerosols and Organic Dusts

Rask‐Andersen¹,

Omland²

2006

Imaging of Occupational and Environmental Disorders of the Chest

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Skin testing in farmers' lung disease

Cited by 9 publications

References 29 publications

Type 3 Hypersensitivity Reaction in Mushroom Growers

Type 3 Hypersensitivity Reaction in Mushroom Growers

Hypersensitivity Pneumonitis

Bio-Aerosols and Organic Dusts

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