RT Journal Article
SR Electronic
T1 Hypersensitivity pneumonitis caused by occupational exposure to phytase
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1507
OP 1509
DO 10.1183/09031936.00035408
VO 33
IS 6
A1 R. C. van Heemst
A1 I. Sander
A1 J. Rooyackers
A1 L. de Jong
A1 R. S. Djamin
A1 J. G. Aerts
A1 H. N. A. Belderbos
YR 2009
UL http://erj.ersjournals.com/content/33/6/1507.abstract
AB A 43-yr-old male presented with a 6-month history of episodes of coughing, shortness of breath and fever. He suffered from dyspnoea on minor exertion. The patient worked in a cattle feed factory and noticed that he had more complaints after his working hours. His symptoms could be ascribed to hypersensitivity pneumonitis due to contact with phytase, an enzyme added to cattle feed to strengthen bone and diminish phosphorus excretion. The diagnosis was supported by bibasal lung crackles on physical examination, restrictive ventilatory defect (with decreased diffusion capacity for carbon monoxide), typical radiographical findings, lymphocytosis in bronchoalveolar lavage fluid and a positive exposure test performed at the workplace. Blood examination showed high immunoglobulin G levels to phytase. After treatment and cessation of phytase contact the patient became symptom free and lung function normalised. Phytase should be considered as a cause of occupational hypersensitivity pneumonitis in the animal feed industry.