title: [A patient with acute hypersensitivity pneumonitis with a diagnosis of air-conditioner lung, who responded to therapy].
abstract: The patient was a 48-year-old woman and current smoker. In May 2007, she moved to a new residence. In the middle of the following month, she developed acute respiratory distress and a fever (38 degrees C) after running her air conditioner continuously throughout the night. The chest X-ray film showed diffuse infiltrative shadows in the middle and lower lung fields. After hospital admission, her oxygenation improved without treatment and the infiltrates improved over the clinical course. As a consequence, we suspected hypersensitivity pneumonitis. The bronchoalveolar lavage showed predominant lymphocytes of 72.6%, with a low CD 4/8 ratio of 0.2. Transbronchial lung biopsy findings corresponded to acute hypersensitivity pneumonitis. The results of the environmental challenge test were positive only when her air conditioner was on, resulting, in a diagnosis of air-conditioner lung. Several microorganisms were detected in an environmental sample, but 20 kinds of serum precipitating antibodies were negative on a thorough screening, so no responsible antigen could be identified. The patient's symptoms did not recur after her air conditioner was replaced.
authors.affiliation: Department of Respiratory Medicine, Japanese Red Cross Medical Center.
authors.forename: Rie
authors.initials: R
authors.lastname: Ishikawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kamiya
authors.forename: Souichiro
authors.initials: S
authors.lastname: Ikushima
authors.forename: Masaru
authors.initials: M
authors.lastname: Oristu
authors.forename: Tamiko
authors.initials: T
authors.lastname: Takemura
mesh_terms: D000208:Acute Disease; D000389:Air Conditioning / Q000009:adverse effects*; D000542:Alveolitis, Extrinsic Allergic / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged