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Case Reports
. 2025 Mar 7;17(3):e80195.
doi: 10.7759/cureus.80195. eCollection 2025 Mar.

Paprika-Induced Hypersensitivity Pneumonitis: A Report of a Rare Case

Xinyu Fu  1 , Chunyu Liu  1 , Pihua Gong  1 , Zhancheng Gao  1
Affiliations
Case Reports

Paprika-Induced Hypersensitivity Pneumonitis: A Report of a Rare Case

Xinyu Fu et al. Cureus. .

Abstract

Hypersensitivity pneumonitis (HP) is an interstitial lung disease caused by exposure to environmental antigens in susceptible individuals. It is a type IV hypersensitivity reaction. The antigens involved in HP are numerous, but their identification is challenging. We report the first clinical case of HP associated with exposure to paprika. The diagnosis was confirmed based on the patient's exposure history, chest imaging, bronchoalveolar lavage fluid analysis, and pathological findings. Avoidance of antigens and treatment with glucocorticoids resulted in symptom relief. Follow-up chest imaging showed no ideal improvement; immunosuppressants or antifibrotic drugs may be considered in combination if necessary. The case highlights that individuals working in paprika production and processing should take preventive measures to avoid chronic pulmonary fibrosis.

Keywords: capsaicin; hypersensitivity pneumonitis; interstitial lung disease; paprika; treatment.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Chest CT on admission
Pulmonary fibrosis (reticular opacities and traction bronchiectasis due to fibrosis formation) and headcheese sign (ground-glass opacities, normally ventilated lung tissue, and areas of air trapping). CT: computed tomography
Figure 2
Figure 2. BALF cell classification and count
The BALF analysis revealed a lymphocyte proportion of 54% (>40%) and macrophages at 38%. Flow cytometry identified CD4+ T cells comprising 85.56% and CD8+ T cells at 10.51%, with a CD4/CD8 ratio of 8.51. This figure was created by the authors using Figdraw (Home for Researchers, Hangzhou, Zhejiang Province, China). BALF: bronchoalveolar lavage fluid
Figure 3
Figure 3. Histopathological findings from TBLC of the posterior basal segment of the right lower lobe: hematoxylin and eosin staining
(A, B) Bronchial and alveolar epithelial cells show active proliferation. Interstitial space reveals chronic inflammatory cell infiltration and collagen deposition. (C, D) Fibrous tissue proliferation is evident, accompanied by granulomas, multinucleated giant cells, and cholesterol crystal deposits. TBLC: transbronchial lung cryobiopsy
Figure 4
Figure 4. Post-treatment chest CT
(A, B) Chest CT after avoiding exposure to chili powder for one month revealed a reduction in inflammation, although fibrosis persisted. (C, D) At the fifth-month follow-up, no significant changes in interstitial inflammation were observed in both lungs compared to the prior scan. CT: computed tomography
See this image and copyright information in PMC

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