Background
Hypersensitivity pneumonitis (HP) refers to a group of disorders caused by a nonatopic immunologic response to an inhaled agent. In its acute or subacute form, hypersensitivity pneumonitis may be a cause of recurrent pneumonitis. In its chronic form, hypersensitivity pneumonitis may insidiously lead to pulmonary fibrosis and end-stage lung disease.
Severe acute or subacute flares can be life threatening,
and recurrent or chronic disease can lead to permanent, severe lung damage.
Although rare, fatal cases of chronic hypersensitivity pneumonitis have been reported in children.
Hypersensitivity pneumonitides are classically considered occupational illnesses and have colorful names reflecting the associated occupation. New sources of exposure causing hypersensitivity pneumonitis are continuing to be identified.
Some of these illnesses and their associated causes are as follows:
Farm worker’s lung – Thermophilic actinomycetes and other pathogens
Winemaker’s lung –Botrytis cinerea
Coffee worker’s lung – Coffee bean dust
Lifeguard’s lung – Aerosolized endotoxin
Poultry worker’s lung – Avian antigens
Laboratory worker’s lung – Rodent antigens
Miller’s lung – Wheat weevil
Woodworker’s lung –Penicillium chrysogenum
Detergent worker’s lung –Bacillus subtilis
Epoxy-resin lung – Phthalic anhydride
Wind instrument lung – Bacteria and/or mold contamination of wind instruments
Feather duvet lung – Organic dust due to goose or duck feathers in duvets or pillows