Division of Respirology, Queen's University, Kingston, Ontario, Canada.
Kingston Health Sciences Centre, Kingston, Ontario, Canada.
BMJ Case Rep. 2024 Aug 12;17(8):e260517. doi: 10.1136/bcr-2024-260517.
Fibrotic hypersensitivity pneumonitis (HP) has a poor prognosis when no antigen is identified, which occurs in many cases. We present a case of HP due to foam exposure in bedding, an unrecognised cause of HP. A woman was referred for dyspnoea and cough. High-resolution chest computed tomography (HRCT) showed a three-density pattern with gas trapping. Pulmonary function tests (PFTs) revealed restriction and reduced diffusing capacity. Bronchoalveolar lavage showed lymphocytosis (43%) and lung cryobiopsy showed fibrosis, lymphocytic infiltration and multinucleated giant cells. She had foam in mattress and pillows but no other exposures. Her symptoms, PFTs, and imaging improved after avoiding foam in her bedding. After re-exposure to a foam pillow, her symptoms, PFTs, and HRCT worsened. Microbiological analysis of the foam pillow reported , known to cause HP. Foam exposure is a novel cause of HP, and foam avoidance can prevent disease progression and death.
纤维化过敏性肺炎 (HP) 在无法确定抗原时预后不良，这种情况在许多病例中都会发生。我们报告了一例由床上用品泡沫暴露引起的 HP，这是一种未被认识到的 HP 病因。一名女性因呼吸困难和咳嗽就诊。高分辨率胸部计算机断层扫描 (HRCT) 显示三密度模式伴气体陷闭。肺功能检查 (PFT) 显示受限和弥散能力降低。支气管肺泡灌洗显示淋巴细胞增多症（43%），肺冷冻活检显示纤维化、淋巴细胞浸润和多核巨细胞。她的床垫和枕头中有泡沫，但没有其他暴露。避免床上用品中的泡沫后，她的症状、PFT 和 HRCT 得到改善。再次接触泡沫枕头后，她的症状、PFT 和 HRCT 恶化。泡沫枕头的微生物分析报告，这种物质已知会引起 HP。泡沫暴露是 HP 的一个新病因，避免接触泡沫可以防止疾病进展和死亡。
