Diagnosis of Interstitial Lung Disease Caused by Possible Hypersensitivity Pneumonitis in a Child: Think CGD

J Clin Immunol. 2017 Apr;37(3):269-272. doi: 10.1007/s10875-017-0376-8. Epub 2017 Feb 21.

Abstract

Interstitial lung disease (ILD) is a rare and heterogeneous group of disorder affecting the lung parenchyma and has a detrimental effect on gas exchange. Chronic granulomatous disease (CGD), when it affects primarily lungs, may cause ILD. We report a 16-year-old patient with CGD caused by homozygous deletion of NCF1 who atypically presented with ILD. The patient had many pigeons and was a pigeon breeder. Exacerbated clinical symptoms were linked to hypersensitivity pneumonitis (HP), and the patient was suggested to keep away from pigeons. In addition to allergen avoidance and prophylactic antibacterial therapy, treatment with corticosteroids and hydroxychloroquine was started for mainly obstructive and persistant symptoms of ILD. CGD is known to cause a hyperinflammatory state and the patients present with excessive granuloma formation and HP. Control of inflammation either by avoidance of allergen exposure and by anti-inflammatory drugs is necessary for the relief of symptoms.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adolescent
  • Alveolitis, Extrinsic Allergic / complications
  • Alveolitis, Extrinsic Allergic / diagnosis*
  • Biomarkers
  • Granulomatous Disease, Chronic / complications*
  • Granulomatous Disease, Chronic / diagnosis*
  • Humans
  • Lung Diseases, Interstitial / diagnosis*
  • Lung Diseases, Interstitial / etiology*
  • Lung Diseases, Interstitial / physiopathology
  • Male
  • Radiography, Thoracic
  • Respiratory Function Tests
  • Tomography, X-Ray Computed

Substances

  • Biomarkers