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Pediatric Hypersensitivity Pneumonitis

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

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