EC Paediatrics

Background: Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, is a rare immune-mediated inflammatory lung disease, particularly uncommon in pediatric patients.

Case Presentation: A six-year-old girl presented with odynophagia, dry cough, and sudden respiratory distress. Pulmonary auscultation revealed decreased air entry bilaterally associated with crackles. Despite initial treatment, her condition deteriorated, prompting admission for further investigation. Imaging revealed bilateral diffuse micronodules on chest radiography and ground-glass opacities on computed tomography. Bronchoalveolar lavage demonstrated lymphocytic alveolitis with a reversed CD4+/CD8+ ratio, suggestive of HP. Positive avian precipitins supported the diagnosis.

Discussion: Diagnosis of HP in pediatric patients is challenging due to its rarity and nonspecific symptoms. Clinical suspicion, supported by imaging and immunological tests, is crucial for accurate diagnosis.

Conclusion: This case underscores the importance of considering HP in pediatric patients with respiratory symptoms, especially in the context of environmental exposure. Early diagnosis and antigen avoidance are essential for favorable outcomes in HP.

 Keyword: Hypersensitivity Pneumonitis; Interstitial Pneumonitis; Extrinsic Allergic Alveolitis; Paediatric

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