title: Progressive dyspnea in a 46-year-old woman.
abstract: BACKGROUND
  Hypersensitivity pneumonitis (HP) is an inflammatory lung disease that requires a high index of suspicion and evaluation for potential causative antigens in the patient's environment.
  
  
  OBJECTIVE
  To describe a patient referred for allergic rhinitis who was found to have progressive dyspnea and was ultimately diagnosed as having HP.
  
  
  METHODS
  The history of progressive dyspnea with findings of diffuse pulmonary crackles on physical examination and restrictive pulmonary function testing prompted further radiologic, pathologic, laboratory, and home environment evaluations.
  
  
  RESULTS
  The constellation of findings from these studies led to the diagnosis of HP secondary to parakeet antigens. Elimination of further antigen exposure and corticosteroid therapy led to resolution of the patient's symptoms.
  
  
  CONCLUSIONS
  Prompt diagnosis and removal of the antigen source are of paramount importance in the management of HP.
authors.affiliation: Department of Allergy/Immunology, Walter Reed Army Medical Center, Washington, DC 20307, USA. rajiv.arora@us.army.mil
authors.forename: Rajiv
authors.initials: R
authors.lastname: Arora
authors.forename: Larry
authors.initials: L
authors.lastname: Hagan
mesh_terms: D000485:Allergens / Q000009:adverse effects / Q000276:immunology; D000542:Alveolitis, Extrinsic Allergic / Q000175:diagnosis* / Q000276:immunology / Q000503:physiopathology; D000818:Animals; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D004417:Dyspnea / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007958:Leukocyte Count; D008875:Middle Aged; D010240:Parakeets / Q000276:immunology; D012129:Respiratory Function Tests
chemical_list: D000485:Allergens; D007074:Immunoglobulin G