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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
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[Interstitial lung disease due to domestic moulds]

A-L Blanc1, L Delhaes, M-C Copin

  • 1Service de pneumologie et immunoallergologie, centre de compétence des maladies pulmonaires rares, CHRU hôpital Calmette, boulevard du Pr-J.-Leclercq, 59037 Lille cedex, France.

Revue Des Maladies Respiratoires
|September 28, 2011
PubMed

Insights

A patient with interstitial pneumonia improved after moving homes, suggesting a link to domestic mold exposure, specifically Stachybotrys chartarum. This highlights the importance of investigating environmental mycotoxins in lung disease.

Area of Science:

  • Pulmonology
  • Environmental Medicine
  • Mycology

Background:

  • Interstitial pneumonia diagnosis can be challenging, particularly when environmental factors are implicated.
  • Fungal exposure in domestic environments is increasingly recognized as a potential contributor to lung disease.

Observation:

  • A 53-year-old patient presented with severe hypoxemia and diffuse ground glass opacities on CT, unresponsive to initial treatments.
  • Bronchoscopy revealed white deposits, and lavage showed lymphocytosis; mold serology indicated a reaction to Stachybotrys chartarum.
  • Lung biopsy confirmed bronchiolocentric interstitial pneumonia.

Findings:

  • The patient's condition significantly improved, with normalization of clinical, radiological, and functional parameters, after relocating to a new residence.
  • The final diagnosis was interstitial lung disease secondary to mycotoxins produced by Stachybotrys chartarum.
  • Pulmonary function tests indicated a moderate restrictive pattern with impaired carbon monoxide diffusion.

Implications:

  • Hypersensitivity pneumonitis or mycotoxin-induced interstitial lung disease should be considered in patients with unexplained interstitial pneumonia.
  • Specific environmental investigations are crucial for identifying mold-related allergens or toxins contributing to lung pathology.
  • Prompt identification and removal of the environmental trigger can lead to significant clinical improvement.

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