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Characterization of emphysema in active farmer's lung disease
PDPI Sumatera Utara, 18 Okt 2017 16:32:48
Characterization of emphysema in active farmer's lung disease

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Thibaud Soumagne1,3, Marie Laure Chardon1, Gael Dournes2, Lucie Laurent1,3, Bruno Degano3, François Laurent2 and Jean Charles Dalphin1,4
1Service de Pneumologie, CHU de Besançon, Besançon, France, 2Service D'Imagerie Thoracique et Cardiovasculaire, CHU de Bordeaux, Pessac, France, 3Service D'explorations Fonctionnelles Respiratoires et EA 3920, CHU de Besançon, Besançon, France, 4UMR/CNRS 6249 Chrono-Environment, Université de Franche-Comté, Besançon, France

Background: Emphysema has been reported in 20% of Finnish patient with chronic farmer's lung disease (FL), twenty years ago. Nevertheless, involved antigens may have changed and imaging technology has improved.

Objectives: (i)to assess the prevalence, (ii)to characterize the functional and radiologic characteristics of emphysema in active FL and (iii)to determine the risk factors associated with emphysema.

Methods: We retrospectively reviewed all incident cases of active FL who had been included in an academic prospective controlled study for synthesizing recombinant antigens1. All patients underwent occupational questionnaires, PFT, 6MWT, broncho-alveolar lavage (BAL), FL precipitin samples and CT-scan (qualitative and quantitative evaluation). Activity of the disease was defined by recurrence of symptoms, lymphocytic alveolitis or disease activity on CT-scan.

Results: We included 37 patients with active FL. Among them 17 (46%) had bilateral emphysema in at least 3 lobes and 3 (8%) had combined pulmonary fibrosis and emphysema. Smoking habits were similar between patients with and without emphysema. TLC was significantly higher and FEV1/FVC and KCO were significantly lower in patients with emphysema in patients (respectively 111% predicted vs. 90%, p < 0.01; 67.4% vs. 81.0% and 71.5% vs. 87.7%; p < 0.05). No differences were found for the BAL cellularity, 6MWT and precipitin samples between the 2 groups. Duration of exposure was significantly higher in patients with emphysema (32.7 years vs 23.3 years p < 0.05). Analysis of risk factors is currently underway.

Conclusion: Prevalence of emphysema in active FL in our series is higher than previously reported. Risk factors need to be determined.

Source : http://erj.ersjournals.com/content/48/suppl_60/PA1163
Image : https://www.unilever.com/Images/...
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