| B-lymphocyte aggregates in alveoli from a child with hypersensitivity pneumonitis (bird breeders lung). | |
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MedLine Citation:
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PMID: 10582714 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Hypersensitivity pneumonitis is an interstitial lung disease mediated through a patient's immunologic response to a variety of inhaled organic dusts. Studies of the cellular components of lavage fluid from patients with this disease show marked increases of CD8+ suppressor/cytotoxic T-lymphocytes. OBJECTIVE: In this study, we identified, in addition to the expected suppressor T-cells and natural killer cells, follicle-like aggregates of B-cells in the lung interstitium of an affected patient. METHODS: The patient was an 11-year-old non-asthmatic, Caucasian male who presented with a 4-month history of progressive dyspnea, cough, and fever. The home contained nine cockatiel and two doves. Admission pulmonary functions revealed a restrictive pattern with diminished diffusion capacity. Prior to a diagnosis, the patient underwent bronchoalveolar lavage and transbronchial biopsy. Serum precipitins were eventually positive to pigeon (which cross-reacts with dove) droppings. The symptoms resolved after a prolonged course of prednisone. RESULTS: Analysis of bronchoalveolar lavage lymphocyte population revealed a predominance of CD8+ cells (50%) with 85% expressing the activation marker HLA-DR. The percentage of CD4+ and CD56+ were 32% and 16%, respectively. The transbronchial biopsy revealed CD20+ follicle-like aggregates within the lung interstitium. CONCLUSIONS: The histopathologic findings confirm that in hypersensitivity pneumonitis, the predominant immune response is an infiltrate of CD8+ T cells. The presence of B cell aggregates, however, may indicate that the local synthesis of antibody may be involved in an antibody-dependent cellular cytotoxic mechanism. |
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Authors:
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J S McClellan; G M Albers; B E Noyes; C Sotelo; J A Petterchak; A P Knutsen |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology Volume: 83 ISSN: 1081-1206 ISO Abbreviation: Ann. Allergy Asthma Immunol. Publication Date: 1999 Nov |
Date Detail:
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Created Date: 1999-12-14 Completed Date: 1999-12-14 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9503580 Medline TA: Ann Allergy Asthma Immunol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 357-60 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, St. Louis University School of Medicine, Missouri, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals B-Lymphocytes / immunology* Bird Fancier's Lung / diagnosis, immunology* Birds / immunology Bronchoalveolar Lavage Fluid / cytology, immunology Child Humans Male Pulmonary Alveoli / immunology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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