Calling Dr. Bauer

Dear Dr. Bauer,

I was told I have “hypersensitivity” lung disease and am unsure what this means! Thanks for any help in understanding.

Evelyn P., Maryland

This is a specific type of interstitial lung disease (ILD) that is more accurately called “hypersensitivity pneumonitis” or HP. HP is caused by an allergic reaction that occurs in the lung when certain organic

proteins are inhaled from the environment. I like to describe it as “poison ivy” that takes place in the lung tissues. This is a very different type of allergy compared to asthma. Signs and symptoms of HP may include fever, chills, muscle or joint pain, or headaches, cough, chronic bronchitis, shortness of breath, weight loss, fatigue, and/or fibrosis of the lungs. HP results in dry cough, fever, and lung scarring. Asthma symptoms are typically wheezing and cough with mucus.

Where I live in upstate New York, I see farmers occa- sionally presenting with “Farmer’s Lung”, an allergic reaction to inhaled dusts commonly seen in the barn. Many causes of HP have been described. A bad reaction to bird dander and droppings from indoor parrots and parakeets is a classic HP. Others include dust associated with grain and flour processing, lumber milling and construction, and veterinary work and animal handling. Diagnosis is best made by your doctor taking a thorough medical history from you. Sometimes a blood test is helpful.

The primary treatment of HP is to stop the exposure! This means the person needs to use an appropriate dust mask with potential expo- sure or even better – stop working in the environment or get the offending agent out entirely. Allergy-causing bacteria and fungus can thrive in stagnant water so be sure to remove any standing water around your home. Immediately repair any water damage including removing water-damaged carpeting, furnishings and drywall. Take efforts to keep the humidity in your home and work below 50 percent. Prednisone or other steroids can quicken recovery. HP should be a preventable and very treatable disease.

Dr. Michael Bauer

Questions for Dr. Bauer? You may write to him at The Pulmonary Paper, PO Box 877, Ormond Beach, FL 32175 or

by email at [email protected] pulmonarypaper.org.