A Case Report: Hypersensitivity Pneumonia

Yıl 2016, Cilt: 7 Sayı: 1, 26 - 28, 24.02.2016

Emel Bulcun , Aydanur Ekici , Mehmet Ekici Aydın Çifci , Ahu Cerit

Öz

A case of hypersensitivity pneumonitis with symptoms of dyspnea and cough, with normal PA chest radiography and with the anamnesis of pigeon exposure was presented here. 66 years old male patient had complaints of dyspnea and cough since 3 months. His respiratory sounds were normal. He did not have other environmental, occupational or drug exposure history.  In thorax high resolution computed tomography (HRCT), there were centriacinar nodules in the middle and lower lobes. When his anamnesis was reevaluated,  we learned that he was cleaning up pigeon droppings from roof every week. The patient was instructed to stop having direct and indirect contact with pigeons. One month after, the patient was reevaluated. His cough and dyspnea were improved. In his followup thorax HRCT, centriacinar nodules were disappeared. We should always consider hypersensitivity pneumonitis in the patients with the complaints of dyspnea, cough, even if the PA radiography is normal; we should take the exposure history comprehensively.

 Key words: Hypersensitivity pneumonia, centriacinar nodules, tomography

Anahtar Kelimeler

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Bir olgu sunumu: Hipersensitivite pnömonisi

Öz

Nefes darlığı, öksürük semptomları ile gelen PA akciğer grafisi doğal olan ancak detaylı anamnezle güvercin maruziyeti öyküsü tarifleyen ve hipersensitivite pnömonisi tanısı alan olguyu sunduk. 66 yaşında erkek hasta üç aydır olan nefes darlığı, öksürük şikayetleri ile polikliniğine başvurdu. Fizik muayenesinde solunum sesleri doğaldı. Çevresel, mesleksel maruziyet ve özellikli bir ilaç kullanım öyküsü yoktu. PA akciğer grafisi normaldi. Toraks yüksek çözünürlüklü bilgisayarlı tomografi (YÇBT)’de orta ve alt loblarda daha belirgin olan yaygın buzlu cam dansitesinde sentriasiner nodüller izlendi. Hastanın evin çatısındaki güvercinlere ait atık ürünlerini haftalık temizlediği öğrenilmesi üzerine güvercinlerle direk ve dolaylı maruziyetinin kesilmesi önerildi. Bir ay sonraki kontrolünde öksürük ve nefes darlığı semptomlarında gerileme olduğu öğrenildi. Kontrol toraks YÇBT’de her iki akciğerde izlenen yaygın sentriasiner nodüllerin kaybolduğu görüldü. Nefes darlığı, öksürük gibi semptomlarla başvuran hastalarda akciğer grafisi normal bile olsa hipersensitivite pnömonisinin de olabileceği göz önünde bulundurulmalı ve hastaların maruziyet öyküsü detaylı olarak sorgulanmalıdır.

Anahtar kelimeler: Hipersensitivite pnömonisi, sentriasiner nodüller, tomografi

Anahtar Kelimeler

Hipersensitivite pnömonisi, sentriasiner nodüller, tomografi

Kaynakça

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