01 December 2011
Pneumomediastinum as a primary manifestation of chronic hypersensitivity pneumonitis
Dirk KoschelABCDEF, Sabin HandzhievBD, Carlos CardosoBD, Axel RolleDEF, Olaf HolotiukCD, Gert HöffkenDEFDOI: 10.12659/MSM.882115
Med Sci Monit 2011; 17(12): CS152-155
Abstract
Background: Patients with chronic hypersensitivity pneumonitis (HP) can present with an insidious onset of their disease without typical fluctuating flu-like symptoms, and there are only signs of chronic respiratory failure caused by the progressive fibrotic lung disease.
Case Report: A 45-year-old man with a pneumomediastinum and interstitial lung disease was referred for further investigations and therapy. No traumatic event or interventional procedure had occurred prior to referral. The patient had been working in farming for almost 20 years and was exposed in childhood by his father to pigeon breeding from childhood until 20 years ago. He reported dyspnea on exercise for the previous 2 years. High-resolution CT of the lung showed a pneumomediastinum and a fibrotic interstitial lung disease without dominating ground-glass opacities. Specific IgG antibodies were markedly elevated against molds and avian antigens. Bronchoalveolar lavage demonstrated a slightly lymphocytic and neutrophilic alveolitis. After recovering from the pneumomediastinum, an open lung biopsy was performed and a UIP-pattern was detected. An inhalative challenge with hay from the work-place was positive. A diagnosis of chronic farmer’s lung was made.
Conclusions: Pneumomediastinum has been described in other fibrotic lung diseases, but until now it has not been described as a primary manifestation of chronic fibrotic HP. Particularly in cases of concurrent antigen sources, an inhalative challenge could be done, even in a chronic course of HP.
Keywords: Respiratory Function Tests, Mediastinal Emphysema - surgery, Lung - surgery, Chronic Disease, Biopsy, Alveolitis, Extrinsic Allergic - surgery, Tomography, X-Ray Computed
981 2
Editorial
01 November 2023 : Editorial
Editorial: Factors Driving New Variants of SARS-CoV-2, Immune Escape, and Resistance to Antiviral Treatments as the End of the COVID-19 Pandemic is DeclaredDOI: 10.12659/MSM.942960
Med Sci Monit 2023; 29:e942960
In Press
30 Nov 2023 : Review article
Decoding the Neurological Sequelae of General Anesthesia: A ReviewMed Sci Monit In Press; DOI:
30 Nov 2023 : Clinical Research
Enhanced Pain Relief and Muscle Growth in Individuals with Low Back Instability: The Impact of Blood Flow R...Med Sci Monit In Press; DOI:
29 Nov 2023 : Clinical Research
Comparative Analysis of Intramedullary Nail versus Plate Fixation for Fibula Fracture in Supination Externa...Med Sci Monit In Press; DOI:
29 Nov 2023 : Clinical Research
Impact of COVID-19 on Academic Burnout among Medical College Students in China: Findings from a Web-Based S...Med Sci Monit In Press; DOI:
Most Viewed Current Articles
13 Nov 2021 : Clinical Research
Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...DOI :10.12659/MSM.932788
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical Research
Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...DOI :10.12659/MSM.935379
Med Sci Monit 2021; 27:e935379
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
08 Mar 2022 : Review article
A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...DOI :10.12659/MSM.936292
Med Sci Monit 2022; 28:e936292