From: Hypersensitivity pneumonitis: lessons for diagnosis and treatment of a rare entity in children
Sex | 9 male of 23 total |
Age at 1st visit (y) | 9.8 ± 3 |
Time to diagnosis (mon) | 1.3 ± 1 |
Initial presentation | |
Chronic cough, dyspnoea at rest, cyanosis, clubbing | 15, 13, 11, 3 of 23 |
Loss of weight per week until diagnosis (kg) | - 0.73 ± 0.49 |
Non-pulmonary diagnoses | Atopic eczema (2), Diabetes mellitus Type I (1), hyperthyreoiditis, adipositas (4), house dust mite allergy (2), bronchial asthma (1), celiac disease (2), small stature (1), hypothyroidism (1), alopecia areata (1), enuresis nocturna (1), vitiligo (1), GERD and nissen fundoplication (1) |
Serum measurements | |
Elevated fungus IgG | 17 of 23 |
Elevated bird IgG | 21 of 23 |
Total IgG (fold upper limit) | 1.2 ± 0.6 |
LDH i. S. (U/l) | 352 ± 189 |
ACE i. S.(U/l) | 53 ± 31 |
Positive serology for mycoplasma | 9 of 17 assessed |
Bronchoalveolar lavage measurements | Done in 17 children |
Total cell count (/μl) | 8800 ± 11017 |
Macrophages (%) | 41 ± 25 |
Lymphocytes (%) | 46 ± 26 |
Neutrophils (%) | 13 ± 13 |
Eosinophils (%) | 2.6 ± 2.1 |
CD4+/CD8+ (% Lymph) | 36 ± 16/48 ± 25 |
CD4/CD8 Ratio | 2.0 ± 2.8 |
Cultured bacteria | None |
Mycoplasma/Chlamydia | 7 negative of 7 assessed for PCR in BAL |
Lung function measurement | Done in 22 children |
FEV1 (% pred) | 44 ± 21 |
FVC (% pred) | 38 ± 15 |
MEF25 (% pred) | 62 ± 45 |
DLCOcHb (% pred) | 52 ± 28 |
SaO2 (%) Rest/excercise | 93 ± 27/83 ± 40 |
pO2 (mmHg) Rest/excercise | 64 ± 34/57 ± 20 |
pCO2 (mmHg) Rest/excercise | 38 ± 20/34 ± 12 |
Lung biopsy | Done in 6 children |