Location
Moultrie, GA
Start Date
4-5-2022 1:00 PM
End Date
4-5-2022 4:00 PM
Description
Introduction
Hypersensitivity pneumonitis is a rare interstitial disorder characterized by an immune reaction of the lung parenchyma, usually to a sensitized allergen. Pneumonitis is a common cause of respiratory decline among those with comorbid conditions such as chronic obstructive pulmonary disease and congestive heart failure. The use of corticosteroids in patients with pneumonitis is well documented, but their role in the treatment is not clearly understood.
Case Presentation
Patient is a 58-year-old female with past medical history of polymyalgia rheumatica, osteoporosis, and current smoker who presented with a three day history of progressive shortness of breath, dyspnea on exertion, orthopnea, weight gain, and a chronic nonproductive cough. The study pointed to the initial diagnosis of congestive heart failure or chronic obstructive pulmonary disease. Further study and diagnostic imaging revealed a case of hypersensitivity pneumonitis. The patient underwent treatment with Solu-medrol, resulting in resolution of symptoms within five days. Repeat chest x-ray and CT pulmonary angiogram on day six showed nearly resolved pneumonia with improving adenopathy.
Discussion
The authors present this case to emphasize the challenging differential diagnosis of hypersensitivity pneumonitis due to the lack of specificity of clinical manifestations and treatment. A multidisciplinary discussion of clinical and radiologic data can play a role in the diagnosis and thus early management of rapid respiratory deterioration.
Included in
Hypersensitivity Pneumonitis: A Clinical Case with Rapid Resolution on Imaging
Moultrie, GA
Introduction
Hypersensitivity pneumonitis is a rare interstitial disorder characterized by an immune reaction of the lung parenchyma, usually to a sensitized allergen. Pneumonitis is a common cause of respiratory decline among those with comorbid conditions such as chronic obstructive pulmonary disease and congestive heart failure. The use of corticosteroids in patients with pneumonitis is well documented, but their role in the treatment is not clearly understood.
Case Presentation
Patient is a 58-year-old female with past medical history of polymyalgia rheumatica, osteoporosis, and current smoker who presented with a three day history of progressive shortness of breath, dyspnea on exertion, orthopnea, weight gain, and a chronic nonproductive cough. The study pointed to the initial diagnosis of congestive heart failure or chronic obstructive pulmonary disease. Further study and diagnostic imaging revealed a case of hypersensitivity pneumonitis. The patient underwent treatment with Solu-medrol, resulting in resolution of symptoms within five days. Repeat chest x-ray and CT pulmonary angiogram on day six showed nearly resolved pneumonia with improving adenopathy.
Discussion
The authors present this case to emphasize the challenging differential diagnosis of hypersensitivity pneumonitis due to the lack of specificity of clinical manifestations and treatment. A multidisciplinary discussion of clinical and radiologic data can play a role in the diagnosis and thus early management of rapid respiratory deterioration.