Hypersensitivity pneumonitis as a cause of airway-centered interstitial fibrosis.

BACKGROUND

Airway-centered interstitial fibrosis (ACIF) has been postulated to be related to environmental exposures.

OBJECTIVE

To describe a patient with ACIF associated with hypersensitivity pneumonitis.

METHODS

We evaluated a patient with a 2-year history of progressive dyspnea and exercise intolerance. We performed computed tomography, pulmonary function tests, and skin prick tests.

RESULTS

The patient's computed tomogram suggested hypersensitivity pneumonitis. Pulmonary function testing demonstrated a restrictive pattern. Results of skin prick tests to chicken, goose, canary, and budgie were negative. However, serum precipitins were positive to serum from pigeon, goose, duck, and chicken feathers. The patient was diagnosed as having ACIF.

CONCLUSION

We believe that ACIF may represent a final common pathway for lung injury due to environmental exposure.