Lentil aspiration leading to likely hypersensitivity pneumonitis
© 2019 Wiley Periodicals, Inc..
RATIONALE: A variety of inhaled antigens have been implicated to cause hypersensitivity pneumonitis (HP). We observed that children force-fed with lentil-based weaning food had persistent respiratory symptoms and radiology similar to HP.
OBJECTIVES: To describe the clinical features of lentil HP.
METHODS: We conducted a retrospective review of records of children with lentil HP attending Pediatric Chest Clinic at a tertiary care hospital in North India from 2008-2018. We included case records with elevated immunoglobulin G (IgG) specific for lentil antigen.
MEASUREMENTS AND MAIN RESULTS: Nine children (seven boys) were identified with median (IQR) age of onset of symptoms and diagnosis at 9 (6, 12) and 11 (10, 16) months, respectively. Chronic cough (100%), shortness of breath (89%), fever (78%), vomiting (56%), and wheezing (33%) were common symptoms. Fine crackles were heard in 33% of children, none had clubbing. CT scans showed nodular opacities and consolidation in 78% and 67% children, respectively. Bronchoalveolar lavage showed increased neutrophils and lymphocytes (67% and 33%, respectively). All children showed rapid remission with systemic steroids (prednisolone), starting at a median dose of 1 (1, 1.1) mg kg-1 day-1 . One child had a clinical relapse which was treated with oral steroids again. IgG specific to lentil antigens was elevated in children with lentil HP (21->200 mgA/L) compared with children with other chronic respiratory illnesses (n = 7, <2-11.4 mgA/L).
CONCLUSIONS: Lentil aspiration is an important cause of HP in infants of weaning age with force-feeding practices. Further studies are needed to identify aspirated antigens which cause HP in aspiration prone children.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2019 |
|---|---|
| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:54 |
|---|---|
| Enthalten in: |
Pediatric pulmonology - 54(2019), 11 vom: 15. Nov., Seite 1781-1786 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Dhochak, Nitin [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Aspiration |
|---|
| Anmerkungen: |
Date Completed 21.04.2020 Date Revised 21.04.2020 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1002/ppul.24463 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM299590577 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM299590577 | ||
| 003 | DE-627 | ||
| 005 | 20231225100651.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2019 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1002/ppul.24463 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0998.xml |
| 035 | |a (DE-627)NLM299590577 | ||
| 035 | |a (NLM)31347305 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Dhochak, Nitin |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Lentil aspiration leading to likely hypersensitivity pneumonitis |
| 264 | 1 | |c 2019 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 21.04.2020 | ||
| 500 | |a Date Revised 21.04.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2019 Wiley Periodicals, Inc. | ||
| 520 | |a RATIONALE: A variety of inhaled antigens have been implicated to cause hypersensitivity pneumonitis (HP). We observed that children force-fed with lentil-based weaning food had persistent respiratory symptoms and radiology similar to HP | ||
| 520 | |a OBJECTIVES: To describe the clinical features of lentil HP | ||
| 520 | |a METHODS: We conducted a retrospective review of records of children with lentil HP attending Pediatric Chest Clinic at a tertiary care hospital in North India from 2008-2018. We included case records with elevated immunoglobulin G (IgG) specific for lentil antigen | ||
| 520 | |a MEASUREMENTS AND MAIN RESULTS: Nine children (seven boys) were identified with median (IQR) age of onset of symptoms and diagnosis at 9 (6, 12) and 11 (10, 16) months, respectively. Chronic cough (100%), shortness of breath (89%), fever (78%), vomiting (56%), and wheezing (33%) were common symptoms. Fine crackles were heard in 33% of children, none had clubbing. CT scans showed nodular opacities and consolidation in 78% and 67% children, respectively. Bronchoalveolar lavage showed increased neutrophils and lymphocytes (67% and 33%, respectively). All children showed rapid remission with systemic steroids (prednisolone), starting at a median dose of 1 (1, 1.1) mg kg-1 day-1 . One child had a clinical relapse which was treated with oral steroids again. IgG specific to lentil antigens was elevated in children with lentil HP (21->200 mgA/L) compared with children with other chronic respiratory illnesses (n = 7, <2-11.4 mgA/L) | ||
| 520 | |a CONCLUSIONS: Lentil aspiration is an important cause of HP in infants of weaning age with force-feeding practices. Further studies are needed to identify aspirated antigens which cause HP in aspiration prone children | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a aspiration | |
| 650 | 4 | |a child | |
| 650 | 4 | |a hypersensitivity pneumonitis | |
| 650 | 4 | |a interstitial lung disease | |
| 650 | 4 | |a lentil | |
| 650 | 7 | |a Immunoglobulin G |2 NLM | |
| 700 | 1 | |a Jat, Kana R |e verfasserin |4 aut | |
| 700 | 1 | |a Lodha, Rakesh |e verfasserin |4 aut | |
| 700 | 1 | |a Kabra, Sushil K |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Pediatric pulmonology |d 1993 |g 54(2019), 11 vom: 15. Nov., Seite 1781-1786 |w (DE-627)NLM012888230 |x 1099-0496 |7 nnns |
| 773 | 1 | 8 | |g volume:54 |g year:2019 |g number:11 |g day:15 |g month:11 |g pages:1781-1786 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1002/ppul.24463 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 54 |j 2019 |e 11 |b 15 |c 11 |h 1781-1786 | ||