MULTIFACTORIAL IMMUNOLOGICAL LUNG-DISEASE - A CASE-REPORT

Background: Allergic asthma, allergic bronchopulmonary aspergillosis, and hypersensitivity pneumonitis are all forms of immunologically medi ated lung disease. Recognition that more than one of these diseases ma y co-exist is necessary for proper patient management. Objective: To r eport a case of extrinsic (cat) asthma, allergic bronchopulmonary aspe rgillosis, hypersensitivity pneumonitis, and potentially fatal asthma. Immunologic mechanisms and treatment of these diseases are discussed. Methods: The study is a case report from a university hospital settin g. Serum precipitating antibodies against avian antigens were measured using gel-diffusion technique. Serum IgE levels were measured and ski n testing was performed to selected antigens. Results: The patient had positive cutaneous reactivity to cat antigen and Aspergillus. Serolog y for allergic bronchopulmonary aspergillosis and serum precipitating antibodies to finch extract were positive. Symptoms improved and predn isone requirements decreased after removal of finches. Conclusion: A c ase of cat asthma, potentially fatal asthma, allergic bronchopulmonary aspergillosis, and hypersensitivity pneumonitis is presented. Early r ecognition and treatment of multifactorial immunologic lung disease wi th avoidance measures and use of corticosteroids can prevent progressi ve respiratory damage.