Clinical features of a new hypersensitivity pneumonitis: Salami brusher’s disease

Ref ID: 18418

Author:

Laura Balzarini, Chiara Mancini, Panagiota Mouzakiti, Maurizio Marvisi.

Author address:

Internal Medicine and Pneumology, Figlie di S. Camillo Clinic, Cremona, Italy

Full conference title:

European Respiratory Congress

Abstract:

We observed 5 consecutive cases of hypersensitivity Pneumonitis (HP) in subjects
working in a salami factory. The workers had to clean the mould growing on
salami’s surface by using a wire brush. The working population was of 30 female
subjects, 5 of them developed a HP (17%).Two were smokers (40%) and, other
two were asthmatic. All patients presented with an acute clinical manifestation
with cough, high fever, dyspnea and hypoxia occurring after a short period after
exposure (240±60 minutes). Three of them presented at the emergency department
and a chest x-ray showed and alveolar interstitial pneumonitis and were treated
as a community acquired pneumonia. Skin prick test were positive for Penicillium
spp in 3 cases and for Cladosporium spp and Aspergillus spp in other 2. The
results of serum immunoglobulin (Ig) G and IgA antibodies against Penicillium
spp were positive in 3 patients, 2 patients were positive to Aspergillus Fumigatus.
Pulmonary function test demonstrated a reduction in diffusing capacity in all 5
patients (60±15% of predicted). A bronchial hyperresponsiveness to methacoline
was present in all the patients, the mean dose of methacoline causing a 20% fall
in FEV1 was 3.63±4.70 mg/mL. BAL data showed a lymphocytosis 44.4±8.2%,
CD4+ were 26.5±6.3%, CD8 + 53.5±8.2. Four patients had a complete recovery
after chancing work, and one was treated with oral steroids for increasing dyspnea
and severe interstitial involvement. Salami’s brusher disease is a new type of
HP, the prevalence is high in exposed subjects, and is common even in smokers.
The disease has an acute clinical onset. The probable antigen is Penicillium, but
Cladosporium and Aspergillus may play a key role.

Abstract Number: 2989

Conference Year: 2011

Link to conference website: http://www.ers-education.org/ersMade/abstract_print_11/files/Abstract_book_2011.pdf

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