Sawahata M, Sakamoto N, Yamasawa H, Iijima Y, Kawata H, Yamaguchi T, Uchida K, Eishi Y, Bando M, Hagiwara K. Propionibacterium acnes-associated sarcoidosis complicated by acute bird-related hypersensitivity pneumonitis.
BMC Pulm Med 2020;
20:288. [PMID:
33160347 PMCID:
PMC7649005 DOI:
10.1186/s12890-020-01327-z]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/28/2020] [Indexed: 01/24/2023] Open
Abstract
Background
The number of reports on sarcoidosis complicated by hypersensitivity pneumonitis (HP) is limited, and most describe cases complicated by chronic bird-related HP. Here, we present for the first time a case with Propionibacterium acnes-associated sarcoidosis complicated by acute bird-related HP.
Case presentation
A 62-year-old man with a past medical history of sarcoidosis was admitted to our department, and chest computed tomography showed diffuse ground-glass opacities, which appeared as he rapidly increased the number of pigeons he kept for a competition. Random transbronchial lung biopsy revealed well-formed non-caseating epithelioid granulomas, which contained positively stained substances on immunohistochemistry using the PAB antibody, a specific monoclonal antibody against P. acnes lipoteichoic acid. Poorly formed non-caseating granulomas without positively stained substances were also detected.
Conclusion
We describe the successful identification of this exceptionally rare case of sarcoidosis complicated by acute bird-related HP in which two morphologically and immunohistologically different types of granulomas were present in the same lung.
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