title: Diagnosis of Interstitial Lung Disease Caused by Possible Hypersensitivity Pneumonitis in a Child: Think CGD.
abstract: Interstitial lung disease (ILD) is a rare and heterogeneous group of disorder affecting the lung parenchyma and has a detrimental effect on gas exchange. Chronic granulomatous disease (CGD), when it affects primarily lungs, may cause ILD. We report a 16-year-old patient with CGD caused by homozygous deletion of NCF1 who atypically presented with ILD. The patient had many pigeons and was a pigeon breeder. Exacerbated clinical symptoms were linked to hypersensitivity pneumonitis (HP), and the patient was suggested to keep away from pigeons. In addition to allergen avoidance and prophylactic antibacterial therapy, treatment with corticosteroids and hydroxychloroquine was started for mainly obstructive and persistant symptoms of ILD. CGD is known to cause a hyperinflammatory state and the patients present with excessive granuloma formation and HP. Control of inflammation either by avoidance of allergen exposure and by anti-inflammatory drugs is necessary for the relief of symptoms.
authors.affiliation: Department of Pediatrics, Division of Immunology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey. salihaeren@yahoo.com.
authors.forename: Saliha
authors.initials: S
authors.lastname: Esenboga
authors.affiliation: Department of Pediatrics, Division of Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Nagehan
authors.initials: N
authors.lastname: Emiralioglu
authors.affiliation: Department of Pediatrics, Division of Immunology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Cagdas
authors.affiliation: Department of Pediatrics, Division of Immunology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: Baran
authors.initials: B
authors.lastname: Erman
authors.affiliation: Sanquin Research and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Martin
authors.initials: M
authors.lastname: De Boer
authors.affiliation: Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Oguz
authors.affiliation: Department of Pediatrics, Division of Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Nural
authors.initials: N
authors.lastname: Kiper
authors.affiliation: Department of Pediatrics, Division of Immunology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
authors.forename: İlhan
authors.initials: İ
authors.lastname: Tezcan
mesh_terms: D000293:Adolescent; D000542:Alveolitis, Extrinsic Allergic / Q000150:complications / Q000175:diagnosis*; D015415:Biomarkers; D006105:Granulomatous Disease, Chronic / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D013902:Radiography, Thoracic; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers