RT Journal Article
SR Electronic
T1 Identification of indoor fungal antigens in assessment of hypersensitivity pneumonitis – an alternate approach
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP OA1607
DO 10.1183/13993003.congress-2019.OA1607
VO 54
IS suppl 63
A1 Fernanda Ines Hernandez Gonzalez
A1 Maria Angeles Calvo
A1 Leonardo Arosemena Angulo
A1 Marcelo Sanchez
A1 Mariana Benegas
A1 Jose Ramirez
A1 Carmen M Lucena
A1 Carlos Agusti
A1 Marc Boada
A1 Raul Castellanos
A1 Sebastian C Rodriguez-Garcia
A1 Irina Bobolea
A1 Ebymar Arismendi
A1 Mariona Pascal
A1 Odette Viñas
A1 Estibaliz Ruiz
A1 Sergio Prieto Gonzalez
A1 Gerard Espinosa
A1 Sandra Cuerpo
A1 Joel Francesqui
A1 Jacobo Sellares
YR 2019
UL http://erj.ersjournals.com/content/54/suppl_63/OA1607.abstract
AB Background: The diagnosis of hypersensitivity pneumonitis (HP) onset after fungal antigens inhalation at home can be challenging. Although an early identification of the inhaled antigen and its complete avoidance are recommended, current strategies for identifying the causal antigen are controversial.Objective: To determine the usefulness of this diagnostic strategy in detecting potentially causative fungal agents in the patient’s home environment.Methods: We selected 8 patients with a multidisciplinary diagnosis of HP in our Interstitial Lung Disease Program at a tertiary referral center. All patients had their serum tested against the standard HP screening antigen panel with a positive antibody response, but without an identified antigen based on patient interviews. A standardized environmental sampling took place at each patient’s home.Results: Up to 64 air and swabs samples (median=40; Interquartile range=17) were collected from each patient’s environment. High numbers of colony-forming units (CFU) (more than 100 CFU/plate or more than 100 CFU/ml) of different species of fungi were identificated in each patient’s home. The most prevalent species were Penicillium spp and Cladosporium herbarum. All the individuals had a positive response on the standard antigens panel to more than 1 antigen from the environmental sample. After identifying the possible causative factor, an exhaustive cleaning and remediation of the affected areas were made.Conclusion: An indoor environmental study may be crucial to avoid the continuation of unrecognized exposure to the causative fungal antigen. This might contribute to the correct diagnosis and appropriate management of patients with HP.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, OA1607.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).