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. 2017 Jun 14;12(6):e0178263.
doi: 10.1371/journal.pone.0178263. eCollection 2017.

Emphysema in active farmer's lung disease

Thibaud Soumagne  1   2 , Marie-Laure Chardon  1   3 , Gaël Dournes  4   5 , Lucie Laurent  1   2 , Bruno Degano  2   6 , François Laurent  4   5 , Jean Charles Dalphin  1   7
Affiliations

Emphysema in active farmer's lung disease

Thibaud Soumagne et al. PLoS One. .

Abstract

Background: Farmer's lung (FL) is a common type of hypersensitivity pneumonitis. It is often considered that fibrosis is the most frequent finding in chronic FL. Nevertheless, three cohort studies have suggested that some patients with chronic FL may develop emphysema. We aimed to evaluate the current prevalence of emphysema in active FL, to describe the radiological and functional features of emphysema in active FL, and to identify risk factors associated with emphysema in this population.

Methods: Patients aged over 18 years with active FL were prospectively recruited through the SOPHIA study (CPP Est; P-2009-521), between 2007 and 2015. Each patient had complete medical history screening, clinical examination, high resolution computed tomodensitometry, bronchoalveolar lavage, pulmonary function tests and serum precipitins.

Results: Among 33 patients with active FL, the prevalence of emphysema in this series of incident active FL cases was higher (48.5%) than that of fibrosis (12%) and was not dependent on smoking habits. Most patients with emphysema did not have lung hyperinflation. The possible risk factors for emphysema in active FL were a longer duration of exposure to organic dusts, and at a higher level.

Conclusion: Emphysema is found in half of patients with active FL and may be influenced by exposure patterns.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of patients included in the study.
* bilateral emphysema in at least three lobes.
Fig 2
Fig 2. HRCT findings in patients with active FL.
Mean of the individual sum of the extent scale for each group. The lungs of each patient were evaluated by lobe. In each lobe, a score of 0 to 4 was given for each of the features, therefore the maximal possible score was 20. # p < 0.01 and ## p < 0.0001; * data available for 20 patients.
See this image and copyright information in PMC

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