HYPERSENSITIVITY PNEUMONITIS IN WORKERS EXPOSED TO ESPARTO GRASS (STIPA-TENACISSIMA) FIBERS

Esparto grass (Stipa tenacissima), which is commonly found in the Medi terranean countries, has a wide variety of uses. Five stucco makers wh o had cough, dyspnea, malaise, and fever after exposure to esparto fib er used in their jobs showed a significant decrease in symptoms when t hey were away from work. Precipitating antibodies against art esparto extract were found in the sera of all patients. Specific IgG antibodie s against the esparto extract were also demonstrated in all patient se ra, as were IgG antibodies to Aspergillus fumigatus and thermophilic m icroorganisms (Micropolyspora faeni and Thermoactinomyces vulgaris) by means of an ELISA method. Esparto activity was inhibited in different ranges by the above antigens by inhibition ELISA. Only A. fumigatus c ould be identified after microbiologic evaluation of the esparto fiber samples. After inhalation challenge tests were performed with esparto extracts, all patients showed significant decreases in forced vital c apacity, transfer lung CO, and PaO2 blood gas from baseline values. Fe ver, chills, malaise dry cough, tachycardia, tachypnea, and rales an c hest auscultation were also observed in all patients. Findings from br onchoalveolar lavage were suggestive of allergic alveolitis. Transbron chial biopsy specimens showed interstitial alveolitis with lymphocyte- macrophage infiltrate and granuloma. Unexposed control subjects did no t exhibit reactivity to any of the tests listed above. The dust derive d from esparto fibers can cause hypersensitivity pneumonitis in expose d subjects. Organisms such as A. fumigatus and thermophilic actinomyce s could be the causative antigens. ''Stipatosis'' might be an appropri ate name for this disorder.