Hypersensitivity Pneumonitis: A Clinical Case

Abstract

The hypersensitivity pneumonitis (HP) or extrinsic allergic alveolitis (EAA) is the paradigm of lung response to inhaled organic and inorganic. It is a relatively rare disease, constituting 2% of cases of interstitial lung diseases. The authors describe a case of a 50 years old man, with occupational exposure to metals and paints, who presented with weakness, easy fatigability on small and medium exertion, nonproductive cough, dyspnea and not quantified weight loss. Physical examination revealed bilateral crackles. The study pointed to the initial diagnosis of sarcoidosis with severe restrictive syndrome, but further study revealed that it was of hypersensitivity pneumonitis by lipid inhalation (paint-related products and lead). The patient underwent treatment with prednisone with poor response, showing improvement only after introduction of azathioprine.The authors present this case to emphasize the importance of history of exposure to any toxic substances, a lack of specificity of clinical manifestations, the need for invasive diagnostic methods and, sometimes, poor response to therapy. doi:10.4021/jmc537w