Chest
Clinical InvestigationsLong-term Physiologic Outcome after Acute Farmer's Lung
Section snippets
Materials and Methods
The population under study consisted of 61 proven cases of farmer's lung. There were 54 men and seven women, with a mean age of 39 years (range, 13 to 71 years). Diagnosis was based on a combination of factors, including known exposure, typical clinical presentation, physical examination, chest roentgenograms, pulmonary function tests, serum precipitins, bronchoalveolar lavage, transbronchial lung biopsy, trephine lung biopsy, and, when doubt still persisted, open lung biopsy. Serum analysis
Results
The number of subjects tested at each time interval varied from 57 at diagnosis to ten at nine or more years after diagnosis. The parameter that showed the greatest change between the acute episode and one year after was Dco (61.5 ± 28.5 percent of predicted vs 92.4 ± 36.9 percent of predicted; n = 11 subjects; p<0.01; Fig 1); Dco was also higher than at diagnosis for the intervals of three to four years and five to six years (p<0.05), but not for the intervals of two years, seven to eight
Discussion
Our data show that after an episode of acute farmer's lung, most farmers do not progress to disabling pulmonary fibrosis even if they stay on their farm. Eventual loss of pulmonary function seems to result more from the initial attack than from continued exposure. Only the outcome of Dco was related to continuous contact with the offending allergen. These results agree with previously reported studies.8, 9 Since all subjects were not restudied at each time interval, results shown in Figure 1,
References (17)
- et al.
Farmer's lung: clinical, pathologic and immunologic study of 24 patients
Am J Med
(1964) - et al.
Farmer's lung: thermophilic actinomycetes as a source of “farmer's lung hay” antigen
Lancet
(1963) - et al.
Farmer's lung: a clinical, radiographic, functional and serological correlation of acute and chronic stages
Thorax
(1968) - et al.
Interstitial lung disease
- et al.
Farmer's lung: an acute granulomatous interstitial pneumonitis occurring in agricultural workers
JAMA
(1958) Farmer's lung: a form of pneumoconiosis due to organic dust
Am J Roentgenol
(1958)- et al.
- et al.
The long term prognosis in farmer's lung
Am Rev Respir Dis
(1968)
Cited by (72)
Identification and Remediation of Environmental Exposures in Patients With Interstitial Lung Disease: Evidence Review and Practical Considerations
2021, ChestCitation Excerpt :To mitigate these costs, some opt for use of respiratory masks or air filtration systems to reduce exposures, although there is little evidence regarding effectiveness or to guide choice of protective modality.96-98 It is also important to note that although eliminating exposure to the inciting antigen is typically recommended, limited direct evidence for effectiveness of that practice exists, particularly in the setting of fibrotic disease.77,99 Exposures undoubtedly contribute to ILD pathogenesis beyond those classically considered environmental ILDs.
Farmer's lung disease: Analysis of 75 cases
2017, Medicina ClinicaRespiratory Allergic Disorders
2016, Primary Care - Clinics in Office PracticeCitation Excerpt :Criteria 2, 3, and 5 are met – in these cases, the diagnosis is first suspected after bronchoalveolar lavage or transbronchial lung biopsy. The mainstay of treatment is reduction of exposure to known irritants and secondarily about prevention and risk reduction.93,95 If, after appropriate steps have been taken to remove the causative against from the environment or the patient from the environment and symptoms persist, then additional treatments may be indicated.
Hypersensitivity Pneumonitis
2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth EditionHypersensitivity pneumonitis: Essential radiologic and pathologic findings
2010, Surgical Pathology ClinicsCitation Excerpt :Avoiding contact with the offending antigen is the cornerstone of hypersensitivity pneumonitis treatment; however, even with cessation the clinical course is variable.2 Active disease typically resolves without sequelae.25 Oral corticosteroids serve to control symptoms but do not appear to effect long-term outcome.7
Manuscript received July 24; revision accepted November 21.
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