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Subacute cor pulmonale in hypersensitivity pneumonitis. A case report
South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|November 13, 1982
Summary
Avian antigen exposure in a non-smoker caused progressive respiratory disease and cor pulmonale. Antigen elimination and medical treatment led to significant, though incomplete, recovery.
Area of Science:
- Pulmonology
- Immunology
- Environmental Medicine
Background:
- Hypersensitivity pneumonitis can arise from occupational or environmental exposures to antigens.
- Avian antigens are a common cause of hypersensitivity pneumonitis, particularly in bird owners.
Observation:
- A 37-year-old non-smoking woman presented with several months of worsening respiratory symptoms.
- Initial chest radiography revealed transient nodular shadowing.
- Pulmonary function tests indicated a primarily obstructive lung disease pattern.
Findings:
- The patient developed cor pulmonale, a serious complication of chronic lung disease.
- Symptoms and radiographic findings improved with antigen avoidance and medical therapy, including diuretics and corticosteroids.
- Despite treatment, the improvement was only partial, suggesting potential for chronic changes.
Implications:
- This case highlights the importance of considering environmental exposures, such as avian antigens, in the differential diagnosis of obstructive lung disease.
- Early identification and elimination of the offending antigen are crucial for managing hypersensitivity pneumonitis.
- Corticosteroid therapy can be beneficial but may not fully reverse established lung damage or cor pulmonale.