Iberoamerican Journal of Medicine
https://iberoamjmed.com/article/doi/10.5281/zenodo.3834307
Iberoamerican Journal of Medicine
Case Report

Bagassosis, rare cause of hypersensitivity pneumonitis: A case report

Tyagi Arun, Jadhav Sagar, Waghmare Manoj, Srivastava AK, Khare AB

Downloads: 2
Views: 1440

Abstract

Hypersensitivity pneumonitis (HP), also called extrinsic allergic alveolitis, is a respiratory syndrome involving the lung parenchyma specifically the alveoli, terminal bronchioles and alveolar interstitium. HP is caused by delayed allergic reaction to variety of antigens like microbes, animal proteins, and low-molecular-weight chemicals. Bagassosis is one such HP caused by repetitive inhalation of bagasse. Though use of bagasse as cause of HP is known, use of bagasse in brick- kiln factory as fuel and its association with HP has not been well documented. We report a case of HP in a brick-kiln worker where bagasse was used as fuel.
A twenty-five years old man, working in a brick kiln for five years, presented with complaints of dry cough, low grade fever and weight loss for one month. He had bilateral lower lobe crackles on auscultation. The history of bagasse, clay and coal dust exposure, clinical presentation and imaging were suggestive of HP. However, being endemic in India, pulmonary tuberculosis was ruled out by negative Mantoux test, sputum for acid fast bacilli and Cartridge Based Nucleic Acid Amplification Test. He was managed with corticosteroids and symptomatic treatment with good response and resolution of clinical signs and radiological changes.

Keywords

Interstitial lung disease; Hypersensitivity pneumonia; Bagassosis

References

1. Coultas DB, Zumwalt RE, Black WC, Sobonya RE. The epidemiology of interstitial lung diseases. Am J Respir Crit Care Med. 1994;150:967-72. doi: 10.1164/ajrccm.150.4.7921471.
2. Lacasse Y, Cormier Y. Hypersensitivity pneumonitis. Orphanet J Rare Dis. 2006;1:25. doi: 10.1186/1750-1172-1-25.
3. Fernández Pérez ER, Kong AM, Raimundo K, Koelsch TL, Kulkarni R, Cole AL. Epidemiology of Hypersensitivity Pneumonitis among an Insured Population in the United States: A Claims-based Cohort Analysis. Ann Am Thorac Soc. 2018;15(4):460‐9. doi: 10.1513/AnnalsATS.201704-288OC.
4. Gruchow HW, Hoffmann RG, Marx JJ Jr, Emanuel DA, Rimm AA. Precipitating antibodies to farmer's lung antigens in a Wisconsin farming population. Am Rev Respir Dis. 1981;124(4):411-5. doi: 10.1164/arrd.1981.124.4.411.
5. Singh S, Collins BF, Sharma BB, Joshi JM, Talwar D, Katiyar S, et al. Hypersensitivity pneumonitis: Clinical manifestations – Prospective data from the interstitial lung disease-India registry. Lung India. 2019;36(6):476-82 doi: 10.4103/lungindia.lungindia_263_19.
6. Hearn CE. Bagassosis: an epidemiological, environmental, and clinical survey. Br J Ind Med. 1968;25(4):267-82. doi: 10.1136/oem.25.4.267.
7. Singh AB, Singh A, Pandit T. Respiratory diseases among agricultural industry workers in India: a cross-sectional epidemiological study. Ann Agric Environ Med. 1999;6(2):115‐26.
8. Fink JN, Ortega HG, Reynolds HY, Cormier YF, Fan LL, Franks TJ, et al. Needs and opportunities for research in hypersensitivity pneumonitis. Am J Respir Crit Care Med. 2005;171(7):792-8. doi: 10.1164/rccm.200409-1205WS.
9. Selman M, Pardo A, King TE Jr. Hypersensitivity pneumonitis: insights in diagnosis and pathobiology. Am J Respir Crit Care Med. 2012;186(4):314-24. 10.1164/rccm.201203-0513CI.
10. Johannson KA, Elicker BM, Vittinghoff E, Assayag D, de Boer K, Golden JA, et al. A diagnostic model for chronic hypersensitivity pneumonitis. Thorax. 2016;71(10):951-4. doi: 10.1136/thoraxjnl-2016-208286.
11. Lynch DA, Rose CS, Way D, King TE Jr. Hypersensitivity pneumonitis: sensitivity of high-resolution CT in a population-based study. AJR Am J Roentgenol. 1992;159(3):469-72. doi: 10.2214/ajr.159.3.1503007.
12. Lacasse Y, Girard M, Cormier Y. Recent advances in hypersensitivity pneumonitis. Chest. 2012;142:208-17. doi: 10.1378/chest.11-2479.
13. Reich JM. Chirping rales in bird-fancier’s lung. Chest 1993;104(1):326-7. doi: 10.1378/chest.104.1.326b.
14. Kokkarinen JI, Tukiainen HO, Terho EO. Effect of corticosteroid treatment on the recovery of pulmonary function in farmer’s lung. Am Rev Respir Dis. 1992;145(1):3-5. doi: 10.1164/ajrccm/145.1.3.
15. Morisset J, Johannson KA, Vittinghoff E, Aravena C, Elicker BM, Jones KD, et al. Use of mycophenolate mofetil or azathioprine for the management of chronic hypersensitivity pneumonitis. Chest 2017; 151(3):619-25. doi: 10.1016/j.chest.2016.10.029.


Submitted date:
05/14/2020

Reviewed date:
05/18/2020

Accepted date:
05/19/2020

Publication date:
05/19/2020

5ec4093c0e8825cb03ba8f8e iberoamericanjm Articles
Links & Downloads

Iberoam J Med

Share this page
Page Sections