RT Journal Article
SR Electronic
T1 Hypersensitivity pneumonitis secondary to foam exposure in mattress and pillows
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e260517
DO 10.1136/bcr-2024-260517
VO 17
IS 8
A1 Coppola Lamas, Maria Alejandra
A1 Boag, Alexander
A1 Dabreo, Dominique
A1 Moran-Mendoza, Onofre
YR 2024
UL http://casereports.bmj.com/content/17/8/e260517.abstract
AB Fibrotic hypersensitivity pneumonitis (HP) has a poor prognosis when no antigen is identified, which occurs in many cases. We present a case of HP due to foam exposure in bedding, an unrecognised cause of HP. A woman was referred for dyspnoea and cough. High-resolution chest computed tomography (HRCT) showed a three-density pattern with gas trapping. Pulmonary function tests (PFTs) revealed restriction and reduced diffusing capacity. Bronchoalveolar lavage showed lymphocytosis (43%) and lung cryobiopsy showed fibrosis, lymphocytic infiltration and multinucleated giant cells. She had foam in mattress and pillows but no other exposures. Her symptoms, PFTs, and imaging improved after avoiding foam in her bedding. After re-exposure to a foam pillow, her symptoms, PFTs, and HRCT worsened. Microbiological analysis of the foam pillow reported Penicillium spp, known to cause HP. Foam exposure is a novel cause of HP, and foam avoidance can prevent disease progression and death.