Working with argan cake: a new etiology for hypersensitivity pneumonitis

BMC Pulmonary Medicine

Table 2 Summary of investigations for the diagnosis of Hypersensitivity pneumonitis

Before specific challenge				After specific challenge *
Cases	Physical examination	Chest X rays	DLCO	Symptoms suggestive of HP^†	DLCO (variation) % predicted^†	CT Scan^†	BAL^‡	Conclusion
1	normal	normal	89%	Yes	78% (-11%)	No specific abnormalities	600000/mL 25.5% lymphocytes	HP
2	normal	normal	118%	Yes	120%	/	/	ODTS
3	normal	normal	63%	Yes	61%	Emphysema	935000/mL 5% lymphocytes	ODTS
4	normal	normal	88%	Yes	62% (-22%)	Localized Ground-glass opacities	600000/mL 18% lymphocytes (not available)	HP
5	normal	normal	68%	Yes	79%	/	/	ODTS
6	normal	normal	85%	/	/	/	/	/
7	normal	normal	79%	/	/	/	/	/
8	normal	normal	86%	/	/	/	/	/
9	normal	normal	95%	Yes	94%	/	/	ODTS

* one-hour challenge (D0) to argan cakes at the workplace, only performed in the 6 subjects with flu-like symptoms in the 8 hours following argan handling.
^† at day 2 after challenge.
^‡ at day 4 after challenge-, only performed in subjects with significant features either on HRCT scan (ground-glass opacities) or pulmonary function tests (more than 10% decrease of DLCO after challenge).
/: not performed.
HP: Hypersensitivity Pneumonitis, ODTS: Organic Dust Toxic Syndrome.

ISSN: 1471-2466