TY - JOUR T1 - Utility of inhalation challenge test using avian egg for hypersensitivity pneumonia JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2019.PA5191 VL - 54 IS - suppl 63 SP - PA5191 AU - Ryo Okuda AU - Takuma Katano AU - Masato Asaoka AU - Yoshinori Uchida AU - Satoshi Ikeda AU - Ryota Ootoshi AU - Erina Tabata AU - Ryota Shintani AU - Hiroko Okabayashi AU - Takashi Niwa AU - Tsuneyuki Oda AU - Akimasa Sekine AU - Hideya Kitamura AU - Tomohisa Baba AU - Shigeru Komatsu AU - Eri Hagiwara AU - Takashi Ogura Y1 - 2019/09/28 UR - http://erj.ersjournals.com/content/54/suppl_63/PA5191.abstract N2 - Background: Antigen identification of chronic hypersensitivity pneumonia is sometimes difficult. Inhalation challenge test is particularly useful for identifying antigen. Using the pigeon egg may enable us to conduct the inhalation challenge test more easily.Objectives: To examine the usefulness of inhalation challenge test using avian egg as an antigen.Methods: After pasteurizing the pigeon egg, the patients inhaled the eggs diluted with saline solution by using a nebulizer. The inhalation challenge test was conducted in cases with suspected bird-related hypersensitivity pneumonia from exposure history, CT images and pathological tissues. After inhalation, body temperature, blood test, X - ray, and pulmonary function test were investigated. Chest CT was additionally conducted depending on the situation.Results: The inhalation challenge test was conducted in 14 cases with suspected hypersensitivity pneumonia. Respiratory symptom worsening appeared in 5 cases. Body temperature (>0.5°C) increased in 6 cases. FVC decrease (>5%) and DLco decrease (>10%) were observed in 4 cases and 5 cases respectively. A-a DO2 decreased by more than 10 Torr in 7 cases. In 9 patients who underwent chest CT, 8 of them admitted the appearance of a new gland-glass opacity. Finally, we judged that 5 cases showed a positive response. All cases experienced no severe reaction related to pigeon egg inhalation, and none needed administration of corticosteroids after the test. Egg-related infections such as Salmonella were not observed in any cases.Conclusions: The inhalation challenge test using sterilized avian egg may be safe and useful for conforming the diagnosis of bird-related hypersensitivity pneumonia.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA5191.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -