Abstract
We encountered two patients who developed summer-type hypersensitivity pneumonitis in the northern part of Niigata Prefecture. A 39-year-old woman was referred to our hospital because of cough, fatigue and fever. Chest X-ray films and chest computed tomographic (CT) images revealed ground-glass opacity, and pulmonary function tests showed restrictive impairment and reduced diffusing capacity. Bronchoalveolar lavage (BAL) showed a low CD4/8 ratio, and the lymphocyte fraction was high. A transbronchial lung biopsy (TBLB) specimen revealed noncaseating granuloma and Masson bodies. The patient's condition improved after treatment with oral prednisolone. Another case was a 46-year-old housewife who was admitted to our hospital because of low-grade fever and exertional dyspnea. Chest X-ray films and CT images showed ground-glass opacity. The lymphocyte fraction in BALF was high, and the CD4/8 ratio was low. TBLB specimen disclosed noncaseating granuloma. Steroid treatment was effective. Serum from both patients contained antibodies to Trichosporon cutaneum and T.asahii. Provocation tests were positive in both cases. Neither patient had any relapse after remodeling the bathroom in the first case, and moved to another house in the second case. Previous reports indicate that summer-type hypersensitivity pneumonitis is rare in the northern part of Niigata Prefecture. However summer-type hypersensitivity pneumonitis may occur in any part of Japan, and in any season.
