Case of summer-type hypersensitivity pneumonitis complicated with IgA nephropathy

BMJ Case Rep. 2019 Jun 18;12(6):e228785. doi: 10.1136/bcr-2018-228785.

Abstract

Association between pulmonary disease and IgA nephropathy (IgAN) has been previously reported. However, no association has been reported between hypersensitivity pneumonitis (HP) and IgAN. Here, we report about a patient with no particular medical history, who experienced worsening dyspnoea in the course of 1 month, with ground-glass opacity on chest CT and no improvement after antibiotic therapy. The patient was diagnosed as having HP based on the history of antigen exposure, detection of Trichosporon asahii-specific antibodies and bronchoscopy findings. Concomitantly, findings of renal biopsy revealed the IgAN diagnosis. The patient underwent corticosteroid therapy, with good outcomes for both HP and IgAN. This is the first report in the literature to describe summer-type HP complicated with IgAN.

Keywords: interstitial lung disease; proteinurea.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Air Conditioning / adverse effects*
  • Alveolitis, Extrinsic Allergic / drug therapy
  • Alveolitis, Extrinsic Allergic / immunology
  • Alveolitis, Extrinsic Allergic / microbiology*
  • Antibodies, Fungal
  • Bronchoscopy
  • Cough
  • Dyspnea / etiology
  • Dyspnea / microbiology*
  • Glomerulonephritis, IGA / drug therapy
  • Glomerulonephritis, IGA / immunology
  • Glomerulonephritis, IGA / microbiology*
  • Housing
  • Humans
  • Immunoglobulin A / immunology
  • Male
  • Middle Aged
  • Radiography, Thoracic
  • Seasons
  • Treatment Outcome
  • Trichosporonosis / diagnosis*
  • Trichosporonosis / drug therapy
  • Trichosporonosis / immunology
  • Trichosporonosis / physiopathology

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Fungal
  • Immunoglobulin A