TY - JOUR T1 - Late-breaking abstract: Hypersensitivity pneumonitis in hairdressers JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P4536 AU - Øistein Svanes AU - Jorunn Kirkeleit AU - Tor B Aasen AU - Lene Svendsen AU - Torgeir Storaas AU - Randi Bertelsen AU - Cecilie Svanes Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P4536.abstract N2 - Specific inhalation challenge (SIC) is a well-established method for diagnosis of occupational asthma caused by persulphate salts in hairdressers. In 8 of 14 hairdressers investigated with SIC we saw a clinical pattern more consistent with hypersensitivity pneumonitis (HP) than asthma. We describe two hairdressers with SIC-findings consistent with a diagnosis of HP.Methods: The patients were challenged on two subsequent days with 10 minutes exposure for 0g (placebo), 5g, 15g and 30g potassium persulphate mixed with 150g lactose.Results: Both patients were non-smoking young women with no history of asthma or allergy and negative specific IgEs. They had experienced repeated work-related episodes of flu-like symptoms, cough and dyspnoea, but not wheezing episodes. In response to persulphate challenge, case 1 got flu-like symptoms, 10% decrease in diffusion capacity for carbon monoxide (DLCO) after 4-5 hours, temperature increase from 36.4 to 37.4 after 12 hours, and 17% decrease in FEV1 after 23 hours. Case 2 responded with flu-like symptoms and shoulder joint pains, temperature increase from 36.5 to 37.3 after 8 hours, 18% decrease in FEV1 after 9 hours, and 35-40% increase in leucocytes. Metacholine challenge test before and after SIC were negative for both cases.Conclusion: In two hairdressers suspected of having persulphate-induced asthma, we found little evidence of current asthma, but following SIC they both presented with flu-like symptoms, temperature rise, and leucocytosis or reduced DLCO. This reaction suggests a specific immunologic reaction more peripherally in the lungs, and is compatible with, though not definitively diagnostic of, hypersensitivity pneumonitis (Munoz, X. et al. CurrOpinAllergy ClinImmunol 2013; 13:151-8). ER -