A case of hypersensitivity pneumonitis in a woodworker: diagnostic challenges and management
DOI:
https://doi.org/10.14456/dcj.2024.59Keywords:
Hypersensitivity pneumonitis, extrinsic allergic alveolitis, wood dust, woodworkAbstract
Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, is an inflammatory lung disease caused by an immune response to environmental antigens. This case report emphasizes the importance of taking an exposure history in a 68-year-old Thai male patient with a history of recurrent pneumonia. Radiological examination revealed multifocal ground-glass opacities, consolidation, and mosaic attenuation, along with bronchoalveolar lavage (BAL) showing lymphocytosis without evidence of infection, autoimmune disease, or lung cancer. The patient's work history revealed a hobby in woodworking with long-term exposure to wood dust and chemicals without proper personal protective equipment (PPE). The patient was diagnosed with non-fibrotic HP. After ceasing woodworking and receiving inhaled corticosteroids (ICS), the patient showed improvement and did not experience recurrence. Follow-up radiological exams and pulmonary function tests showed progressive improvement. Diagnosing HP is challenging due to its varied and nonspecific clinical features. Woodworking poses a risk for HP due to exposure to wood dust, fungi, and chemicals. Implementing a hierarchy of hazard control management can effectively reduce exposure and prevent HP and other occupational diseases.
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