Hypersensitivity Pneumonitis – Identifying the Causal Agent

Details

• Corporate Authors:
  Michigan State University. College of Human Medicine
• Description:
  Hypersensitivity Pneumonitis (HP) is a difficult disease to diagnose, particularly to identify the causal antigen. Since the primary treatment modality is to remove the patient from exposure, identification of the causal antigen is extremely important. A patient whose disease is recognized at an early stage and is removed from exposure will usually have complete reversal of their symptoms, as well as reversal of their radiographic and pulmonary function abnormalities. We previously described a cluster of HP patients in southwest Michigan associated with machining (i.e. grinding, drilling) metal while using water based metal working fluids (coolants) (Gupta and Rosenman, 2006).These cases with ground glass changes on their high resolution chest CT scans, restriction and decreased diffusing capacity on their pulmonary function testing were diagnosed early in the development of their disease and had reversal of their findings one to six months after removal from exposure. Unfortunately many patients with HP are first thought to have common conditions, such as pneumonia or sarcoidosis and the association of their lung symptoms with an exposure is not appreciated. Commercially available hypersensitivity panels that measure IgG antibodies in the patient's serum to bacteria, fungus or bird protein may be useful in identifying the causal antigen (See Appendix I). However, in a large percentage of HP patients these commercially available tests are negative since the causal antigen in the environment of the patient is not included in the commercially available panel. Another issue is that antibodies may be present after exposure to one of these antigens in the absence of disease, so a positive result, although suggesting the importance of that antigen in the etiology of the patient's HP, may be a marker of exposure but not involved in the pathophysiology of the disease. [Description provided by NIOSH]
• Subjects:
  Biomarkers Diagnosis Epidemiology Lung Diseases Manufacturing And Industrial Facilities Occupational Exposure Occupational Health Respiratory Tract Diseases Safety
• Keywords:
  Diagnostic Tests Hypersensitivity Pneumonitis Lung Disease Machinists Metalworking Fluids MWFs Occupational Exposure Surveillance
• Publisher:
  Michigan State University-College of Human Medicine
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Newsletter
• Place as Subject:
  Michigan ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-4
• Volume:
  22
• Issue:
  2
• NIOSHTIC Number:
  nn:20054548
• Citation:
  Project S.E.N.S.O.R. News 2011 Apr; 22(2):1-4
• Contact Point Address:
  MSU-CHM, 117 West Fee Hall, East Lansing, MI 48824-1316
• Federal Fiscal Year:
  2011
• Performing Organization:
  Michigan State University
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Project S.E.N.S.O.R. News
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:62ba985d8a6c1be15f64b46797e8e98d53b4367d6045e36eba9a92f9873830ea97d00a2ae14391c7e0a8d5ca3f559985c4404b50d458e0f5903dfca9a1dbfbfd
• Download URL:
  https://stacks.cdc.gov/view/cdc/217076/cdc_217076_DS1.pdf
• File Type:
  [PDF - 169.27 KB ]