Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 14, 2022; 10(2): 741-746
Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.741
Occupational fibrotic hypersensitivity pneumonia in a halogen dishes manufacturer: A case report
Min Wang, Hao-Hui Fang, Zi-Feng Jiang, Wei Ye, Rong-Yu Liu
Min Wang, Zi-Feng Jiang, Rong-Yu Liu, Department of Geriatric Respiratory and Critical Care, the First Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
Min Wang, Hao-Hui Fang, Department of Respiratory and Critical Care, Anhui Chest Hospital, Hefei 230001, Anhui Province, China
Wei Ye, Department of Pathology, Anhui Chest Hospital, Hefei 230001, Anhui Province, China
Author contributions: Wang M analyzed the data and wrote the manuscript; Fang HH assisted in the manuscript preparation; Jiang ZF and Ye W collected clinical data; Liu RY revised the manuscript; all authors have approved the final version to be published.
Informed consent statement: Informed consent was obtained from the patient before all procedures described in the report as well as for the use of the patient’s clinical information and images for publication.
Conflict-of-interest statement: The authors declare that there is no conflict of interest related to this report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rong-Yu Liu, MD, PhD, Chief Doctor, Professor, Department of Geriatric Respiratory and Critical Care, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Street, Hefei 230001, Anhui Province, China. rongyuliu@163.com
Received: August 19, 2021
Peer-review started: August 19, 2021
First decision: November 1, 2021
Revised: November 12, 2021
Accepted: December 7, 2021
Article in press: December 7, 2021
Published online: January 14, 2022
Processing time: 145 Days and 14.7 Hours
Abstract
BACKGROUND

Fibrotic hypersensitivity pneumonitis (FHP) is an allergic and diffuse pneumonia caused by repeated inhalation of antigenic substances, and sometimes developed in people working in specific environments. While novel antigens and exposures continued to be described, physicians should maintain a high suspicion of potential exposures. A detailed assessment of the patient's occupational exposures as well as living environment is necessary and complete allergen avoidance is the first and most important step in the management of FHP once the allergens are determined.

CASE SUMMARY

A 35-year-old female was admitted to the hospital with a cough and breathing difficulties for more than one year. She was a nonsmoker and a manufacturer of halogen dishes, which are characteristic Chinese foods, for 15 years without any protection. High resolution computed tomography of the chest demonstrated an interstitial pneumonia pattern. Pulmonary function examination showed restricted ventilation dysfunction and a significant reduction in dispersion ability. Cell differentiation in bronchoalveolar lavage fluid demonstrated lymphocytosis (70.4%) with an increased lymphocyte CD4/CD8 ratio (0.94). Transbronchial lung biopsy combined with lung puncture pathology showed diffuse uniform alveolar interval thickening, chronic inflammatory cell infiltration, a proliferation of tissue in the bronchial wall fiber and alveolar epithelial follicle degeneration, resulting in fibrosis.

CONCLUSION

Exposure to spices used for the production of halogen dishes may cause FHP.

Keywords: Halogen dishes; Inhalation; Interstitial pneumonia; Spices; Fibrotic hypersensitivity pneumonitis; Case report

Core Tip: Fibrotic hypersensitivity pneumonitis (FHP) is a disease related to immunological response to an inhaled antigen. Avoiding contact with susceptible antigen is the key. Here, we report a case of FHP in a halogen dishes manufacturer probably associated with exposure to the spices. We recommend to enhance respiratory protection during the production of such dishes to prevent this lung disease.