Özlem GÖKSAL, Yavuz Selim DEMİREL, Arif Hikmet ÇIMRIN

General aspects of hypersensitivity pneumonitis in Turkey

Türkiye'de bugüne kadar bildirilen hipersensitivite pnömonitisi prevalans oranları tetikleyici antijenlere maruz kaldığı bilinen popülasyonda %5 ile 15 arasındadır. Türkiye'de hipersensitivite pnömonitisinin genel görünümünü sunmayı ve böylece gelişmekte olan ülkelerde göreceli olarak sık bir hastalığa ilgi çekmeyi amaçladık. Arama motorları ile Türkiye'den bildirilen olgular belirlendi. Elektronik veri tabanlarına kaydedilmeyen diğer dergi ve toplantı özetleri ise ayrıca incelendi. On üç yayından 22 olgunun demografik, klinik özellikler, çevresel ve mesleksel maruziyetler, tanısal yöntemler ve prognostik verileri çıkartıldı. Hastaların çoğu kadın (%68.2) ve kanatlı ile temas öyküsü pozitifti (%59). Ortalama maruziyet süresi 69 ± 77.6 aydı. En sık olarak bidirilen klinik form kronik hipersensitivite pnömonitisiydi (%58.8). Temel patolojik bulgu retikülonodüler paterndi (%45). Zorlu vital kapasite (FVC) restriktif bozukluk ve karbon monoksit difüzyon kapasitesinde azalma solunum fonksiyon testlerinde saptanan başlıca patolojilerdi. En sık patolojik bulgu insterstisyel fibrozisti (%61.5).Yetmiş milyon nüfustan bildirilen az sayıda kanatlılara maruziyetiyle kronik hipersensitivite pnömonitisi olması pek çok hipersensitivite pnömonitisi olgusunun özellikle akut formların göz ardı edildiğini düşündürmektedir. Ayrıca, hipersensitivite pnömonitisi ihmal edilen bir meslek hastalığı olarak görünmektedir. Mevcut durum gelişmekte olan ülkelerde sık karşılaşılan bir durum olarak kabul edilmeli ve mesleksel olarak risk altındaki gruplarda gecikmeden incelenmelidir.

Türkiye'de hipersensitivite pnömonitisinin durumu

Hypersensitivity pneumonitis prevalence rates are between 5 and 15% of the overall population exposed to known inciting antigens but a small number of cases have been reported from Turkey until now. We aimed to present a broad picture of hypersensitivity pneumonitis in Turkey, thus promoting interest in this relatively common disease in developing countries. Search engines were utilized to retrieve the cases reported from Turkey. Other published journals and meeting abstracts which have not been registered into electronic databases were manually reviewed. Twenty-two cases from 13 reports were characterized by demographics, clinical features, occupational and environmental exposures, diagnostic tools and prognostic data. The majority of the group consisted of women (68.2%) and had a positive history for contact with an avian (59%). Mean exposure period was 69 ± 77.6 months. The most common reported clinical form was chronic hypersensitivity pneumonitis (58.8%). Reticulonodular pattern was the basic pathological finding (45%). Restrictive impairments of the forced vital capacity (FVC) and carbon monoxide diffusing capacity (DLCO) of the lungs were the basic pathologies observed in pulmonary function tests. Interstitial fibrosis was the most common pathological finding (61.5%). Few cases reported with preponderance of chronic hypersensitivity pneumonitis with avian exposure from 70 million populations suggest that many hypersensitivity pneumonitis cases, especially acute forms, have been ignored. Also, hypersensitivity pneumonitis somehow appears to be a neglected occupational disease. The present situation should be considered as a common problem currently faced by developing countries and occupational groups under risk must be investigated promptly.

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