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  • Title: [A case of severe summer-type hypersensitivity pneumonitis treated with high-dose administration of steroid].
    Author: Arai M, Kawada H, Kaburagi T, Sakai N, Kudou Y, Kawakami M, Konno K, Takizawa T.
    Journal: Nihon Kyobu Shikkan Gakkai Zasshi; 1991 Nov; 29(11):1457-63. PubMed ID: 1770686.
    Abstract:
    A 40-year-old man who lived in a wooden house built 30 years ago presented with complaints of fever, dry cough and dyspnea. Chest X-ray findings showed interstitial shadows throughout bilateral lung fields. After admission, high-dose administration of 3000 mg of methylprednisolone was performed because of deterioration of chest X-ray shadows and symptoms. In a week, clinical data and symptoms improved. Findings of BAL fluid on admission revealed a relative increase of lymphocytes, neutrophils and mast cells, and pathological findings of transbronchial lung biopsy revealed non-caseous granulation and alveolitis. Precipitating antibodies and indirect fluorescent antibodies against Trichosporon cutaneum and Cryptococcus neoformans had positive reactions and T. cutaneum was isolated and identified from the patient's house. A diagnosis of summer-type hypersensitivity pneumonitis was made according to the criteria advocated by Ando et al. This seemed to be a rare case of summer-type hypersensitivity pneumonitis prolonged after isolation from his normal living environment, successfully treated by high-dose administration of steroid.
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