Thibaud Soumagne1,3, Marie Laure Chardon1, Gael Dournes2, Lucie
Laurent1,3, Bruno Degano3, François Laurent2 and Jean
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
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.
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.
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.
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.
of emphysema in active FL in our series is higher than previously
reported. Risk factors need to be determined.