Farmer’s Lungs Disease: It’s Take A Breath Away!
Farmers were evaluated for the presence of farmer’s lung disease by serologic methods and by clinical histories. Farmer’s lung disease (FLD) is a form of hypersensitivity pneumonitis (HP) caused by inhaling microorganisms from hay or grain stored in conditions of high humidity in the agricultural workplace. The epidemiology of the disease is not well known, and is based on studies conducted by Central European and Asian groups. The clinical presentation may vary, differentiating the chronic (exposure to lower concentrations of the antigen over a longer period time) and the acute forms (after exposure to high concentrations of the antigen). It is more common in middle-aged men, although this probably reﬂects differences in exposure levels. It is also more common in non-smokers, probably because tobacco reduces the IgG response to inhaled antigens, affects cytokine production, and alters macrophage function. The etiology of the disease is clear - the inhalation of mouldy hay dust - and much can be done to prevent it ifthis is borne in mind. Mouldy hay dust is a very complex material consisting of innumerable fungal spores, hyphae and bacteria and fragments of vegetable matter. The treatment of FLD is based mainly on avoiding exposure to the antigen. This is the only measure that has been shown to delay disease progression. Corticosteroids are traditionally recommended in patients with impaired lung function and beta agonist and alpha blockers are also helpful in the treatment of disease.
2. C.P.W, Warrna, MB,FRCP[C];19Feb1977;Lungs disease in farmer;Cma Ejournal;VOL:116;pg. no:391.
3. Dales E,Robert,Munt W,PETER ;Oct1982,Faemers lung disease ,Can Fam Physician;28,pg.no:1817.
4. Seal R.M.E,Thomas G.O,Griffiths J.J;Farmers Lungs; Section of Radiology; Proceedings of The Royal Society Of Medicine; pg. no:272-273.
5. Kirkhoran S.R; Agricucultural Respiratory Hazards And Disease/Module 4;Partners In Agricultural Health;page:1-19.
6. Kurup v.p. at al;Nov 10,2005;Hypersensitivity pnemonitis; The Indian Journal Of Chest Disease & Allied Science;2006;48;116.
7. Morell F,Roger A,Reyes L,Cruzm-j,MURIO C,Mufloz X;2008;Bird Fancior Lungs; A series of 86 patients,medicine;Baltimore,87;110-30.
8. Soumagne T, Chardonml, Doumes G., Laurent L., Degano B.,at al;2017;Emphysima in active farmers lungs;PLOSONE;12(6),e0178263.
9. Trahan S, Hanak V, Ryu JH, Myers JL;2008;Role of surgical lung biopsy in separating chronic hypersensitivity pneumonia from usual intestitial pneumo nia/idiopathic pulmonary ﬁbrosis:analysis of 31 biopsies from 15 patients;Chest.;134:126–32.
10. Keir GJ, Maher TM, Ming D;2014;Rituximab in severe, treatment-refractory interstitial lung disease;Respirology.;19:353–9.
11. Lota HK, Keir GJ, Hansell DM, Nicholson AG, Maher TM, Wells AU, et al;2013;Novel use of rituximab in hypersensitivity pneumonitis refractory to conventional treatment;THORAX;68:780–1.
12. Kern RM, Singer JP, Koth L, Mooney J, Golden J, Hays S, et al;2015;Lung transplantation for hypersensitivity pneumonitis;Chest;147:1558–65.
13. Kokkarinen JI, Tukiainen HO, Terho EO;1992;Effect of corticosteroid treatment on the recovery of pulmonary function in farmer’s lung; AM REV RESPIR DIS.;145:3–5.
14. Dalphin JC, Pernet D, Reboux G, Martinez J, Dubiez A, Barale T, et al;1991;Inﬂu ence of mode of storage and drying of fodder on thermophilic actinomycete aerocontamination in dairy farms of the Doubs region of France;THORAX;46:619–23.
15. Mufloz X,Sanchez-ortiz M,Torres F,Villar A,Morellf,Cruz-M-J;2014;Diagnostic yield of specific inhalation challenge in hypersensitivity pneumonitis,Eur Respir J;44;1658-65.
16. Hapke EJ, Seal RM, Thomas GO, Hayes M, Meek JC;1968; Farmer’s lung; A clinical, radiographic, functional, and serological correlation of acute and chronic stages;Thorax.;23:451–68.
17. Hendrick DJ, Marshall R, Faux JA, Positive Krall JM;1980;Alveolar responses to antigen inhalation provocation tests;their validity and recognition;Thorax;35:415–27.
18. Meyer KC, Raghu G, Baughman RP, Brown KK, Costabel U, Bois du RM, et al;2012; An ofﬁcial American Thoracic Society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease; Am J Resp Crit Care Med;1004–14.
19. Lacasse Y, Fraser RS, Fournier M, Cormier Y;1997;Diagnostic accuracy of transbronchial biopsy in acute farmer’s lung disease;Chest.;112: 1459–65.
20. Pajares V, Puzo C, Castillo D, Lerma E, Montero MA, Ramos-Barbón D, et al; 2014; Diagnostic yield of transbronchial cryobiopsy in interstitial lung disease:a ran domized trial.Respirolog.;19:900–6.
21. Pajares V, Puzo C, Castillo D, Lerma E, Montero MA, Ramos-Barbón D, et al; 2014; Diagnostic yield of transbronchial cryobiopsy in interstitial lung disease:a ran domized trial.Respirolog.;19:900–6.
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