jean robert
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A 60 y.o. farmer presents with a 15 year history of increasing dyspnea.The radiograph of chest shows a bilateral increase in linear markings, and pulmonary function tests reveal reduced FVC with relatively normal FEV1 value. Lung biopsy shows interstitial infiltrates of lymphocytes and plasma cells, minimal interstial fibrosis, and small granulomas. The most likely cause of this clinical and pathologic picture is
a) Chronic inhalation of silica particles
b) Prolonged exposure to asbestos
c) Hypersensitivity to spores of actinomycetes
d) Previous episode of ARDS
e) Autoantibodies that react with alveolar basement membranes
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C?
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c) Hypersensitivity to spores of actinomycetes
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c) Hypersensitivity to spores of actinomycetes
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| jean robert
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This patient has "farmer s lung" which is a form of hypersensitivity pneumonitis caused by inhalation of actimomyces spores. These spores conatain the antigen that incites the hypersensitivity reaction. Because type III (early) abd Type IV immune hypersensitivity reactions are involved, granuloma formation can occur.
The disease abates when the patient is no longer exposed to antigen.Chronic exposure can lead to more extensive interstitial lung disease.
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