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Abstract
Case Report
A case of summer-type hypersensitivity pneumonitis diagnosed after environmental investigation and a provocation test
Koji Takayamaa Jin Kuramochia Naohiko Inaseb
a Department of Internal Medicine, Kuramochi Hospital
b Department of Integrated Pulmonology, Tokyo Medical and Dental University
ABSTRACT
A 59-year-old man presented with fever and exertional dyspnea in August 2008. He was diagnosed as having acute hypersensitivity pneumonitis (HP) on the basis of thoracic computed tomography, bronchoalveolar lavage (BAL), and transbronchial lung biopsy. Serum anti-Trichosporon antibody was negative then. He was suspected to have farmer’s lung because his neighbor was a farmer. Steroid therapy was started, and his symptoms had improved. Because fever and dyspnea recurred during tapering of steroid, he was admitted to our hospital. After environmental investigation, several diseases including isocyanate-induced HP, farmer’s lung, bird-related HP, and summer-type HP had to be differentiated. We reexamined specific antibodies both in serum and BAL fluid. He was diagnosed as having summer-type HP because of positive anti-Trichosporon antibodies and a positive home-returning provocation test. Environmental investigation and a strict provocation test were helpful for the diagnosis of HP.
KEYWORDS
Summer-type hypersensitivity pneumonitis Anti-Trichosporon antibody Environmental investigation Environmental provocation test
Received 25 April 2011 ／ Accepted 25 Oct 2011
AJRS, 1(2): 119-123, 2012
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