MPs question health chiefs over troubled NHS computer programme

Résumé fourni par la source

Introduction: Up to 5% to 10% of cases of idiopathic pulmonary fibrosis (IPF) may actually be hypersensitivity pneumonitis (HP) that has been erroneously diagnosed. The hypothesis of this study is that exposure to a feather-filled duvet or pillow can be a cause of pulmonary fibrosis that is erroneously diagnosed as IPF. Material and methods: Between 2004 and 2010, 318 consecutive patients were studied. The diagnosis was based on internationally established criteria. Emphasis was placed on detecting transitory exposure to a possible environmental agent, particularly the use of a feather duvet or pillow. Furthermore, in patients whose questioning revealed exposure to an uncommon causal antigen or low-intensity exposure, specific IgG to antigen extract was determined, and specific bronchial challenge (SBC) were carried out. Surgical lung biopsies (SLB) were reviewed. Results: 60 patients were diagnosed with IPF. 24 patients had previous contact with a feather duvet or pillow for at least one year. In 15 patients the final diagnosis was HP; 8 by SBC and 2 by characteristic pathologic findings. HP was diagnosed in 3 patients with atypical usual interstitial pneumonia in SLB+ positive IgG testing and in 2 patients with bronchoalveolar lavage lymphocytosis (>20%) and positive specific IgG to the causal agent. In 36 patients without previous contact, HP was diagnosed in 8 patients. Conclusion: In IPF, thorough clinical questioning can reveal the existence of a low-intensity, but persistent exposure to a known causal agent. HP due to exposure to a feather duvet can be the cause of some cases of pulmonary fibrosis, a condition that can have different prognosis. This abstract in funded in part by Fis PI1001577

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