Clinical Case Database / Category: Patient Management
Hypersensitivity pneumonitis
Publication details
Dr Hannah Quin, Dr Marta Babores, Dr Sriram Iyer, Dr Rosemary Trafford
Foundation Years Journal, volume 9, issue 4, p.27 (123Doc Education, London, April 2015)
Abstract
A 63 year old female with a previous radiological diagnosis of hypersensitivity neumonitis (HP) presented to the Accident and Emergency Department for the third time in 8 years. No known allergen had been identified. She complained of progressive shortness of breath, a dry cough and a significant reduction in exercise tolerance. Salient investigations included an arterial blood gas (ABG) which confirmed hypoxia and a high resolution CT (HRCT) scan of the chest revealing bilateral interstitial pulmonary infiltrates. A diagnosis of recurrent HP was made and the allergen identified as goose feather from household bedding products.
HP is a relatively uncommon, yet important cause of progressive breathlessness. It is caused by recurrent inhalation and sensitisation to certain allergens resulting in a hypersensitivity reaction. It is treated with oral corticosteroids. If left untreated it can progress to irreversible pulmonary fibrosis. Identifying the allergen to facilitate allergen avoidance is crucial to its management. This case highlights the process of investigating and managing patients with HP, the challenges of identifying the responsible allergen and how this impacts patient prognosis.
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Authors
Dr Hannah Quin
Macclesfield District General Hospital
Victoria Road, Macclesfield, Cheshire, SK10 3BL
hannah.quin@nhs.net
Dr Marta Babores
Macclesfield District General Hospital
Victoria Road, Macclesfield, Cheshire, SK10 3BL
marta.babores@nhs.net
Dr Sriram Iyer
Macclesfield District General Hospital
Victoria Road, Macclesfield, Cheshire, SK10 3BL
sriram.iyer2@nhs.net
Dr Rosemary Trafford (Corresponding author)
Macclesfield District General Hospital
Victoria Road, Macclesfield, Cheshire, SK10 3BL
rosemary.trafford@nhs.net
References
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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