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Lung Fibrosis in Hypersensitivity Pneumonitis (6)

There were no significant differences in ages between the two groups. The presence of granuloma was not always observed and was not correlated with pulmonary fibrosis (Table 1).
The mode of onset was strongly related to the development of lung fibrosis. Nine of nine patients with insidious onset had lung fibrosis, whereas eight of eight patients with acute onset had no fibrosis (Table 1).
Lung Fibrosis and Pulmonary Function Tests
Analyses of pulmonary function tests in two groups are summarized in Table 2. The fibrosis group showed significantly reduced vital capacity, residual volume, and total lung capacity when compared with the nonfibrosis group. However, there were no differences between the two groups in the parameters for diffusing capacity (Deo, Dco/Va), parameters for small airway (V50/V25, CC/TLC, and delta N2), and arterial Po2. Slightly lower arterial Pco2 in the nonfibrosis group as compared with the fibrosis group might be related to acute onset of this group. Differentials of BAL cells were summarized in Table 3. Although no significant differences were observed in the recovery of BAL fluid between the two groups (data not shown), there was a significant increase in number of lymphocytes and neutrophils in the nonfibrosis group as compared with the fibrosis group.

Table 2—Comparison of Results of Pulmonary Function Tksts Between Nonfibrosis Group and Fibrosis Group

Nonfibrosis (n = 8) Mean ±SD Fibrosis (n = 9) Mean ± SD p Value
%vc 96.5± 18.5 78.1 ±22.4 0.047t
%RV 82.1 ±31.3 55.9±24.7 0.042t
%TLC 88.2 ±14.4 71.6± 17.2 0.028t
RV/TLC 36.1±9.4 35.4± 15.8 NS
FEV,% 83.3 ±7.2 86.1±8.0 NS
V50/V25 4.2± 1.2 4.3± 1.6 NS
CC/TLC 41.9±8.3 42.6 ±13.4 NS
dN*% 1.1±0.6 1.9± 1.9 NS
%Dco 73.6 ±20.5 64.3 ±24.5 NS
Dco/VA 3.3 ±0.6 3.5±0.9 NS
Po* 84.9 ±12.8 82.1± 11.8 NS
Pco2 34.9±2.7 39.6 ±3.5 0.004t

Table 3—Comparison of Cellular Composition of BAL Fluids Between Nonfibrosis Group and Fibrosis Group

Nonfibrosis Mean ± SD Fibrosis Mean ± SD p Value
Total cell 78.90 ±25.77 36.39 ±21.95 0.002t
Macrophages 14.49 ±6.05 13.77 ±12.95 NS
Neutrophils 2.60± 1.81 1.04± 1.04 0.043t
Eosinophils 0.80 ±0.78 1.39±3.21 NS
Mast cells 0.91 ±2.01 0.04 ±0.07 NS
Lymphocytes 59.79 ±23.23 20.04 ±17.85 O.OOlf
T cell 51.64±21.20 17.36 ±15.49 0.002t
В cell 1.95 ± 1.02 0.95 ±0.92 NS
CD4 11.35 ±4.96 9.94 ±10.81 NS
CD8 37.00 ±15.83 4.83±4.19 o.ooot
CD4/CD8 0.31 ±0.13 2.59 ±2.63 0.027f

Category: Pulmonary disease

Tags: hypersensitivity, hypersensitivity pneumonitis, pulmonary fibrosis, pulmonary function

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