Occupational Asthma Reference

Tanaka Y, Shirai T, Enomoto N, Asada K, Oyama Y, Suda T, Occupational hypersensitivity pneumonitis in a green tea manufacturer, Respirology Case Reports, 2016;4:e00152,10.1002/rcr2.152

Keywords: HP, histology, green tea, new cause, Japan

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Hypersensitivity pneumonitis (HP) is caused by numerous agents, and one of its histopathological features is poorly formed granulomas. We report here a rare case of occupational HP caused by green tea, showing well-formed granulomas. The patient, a 54-year-old woman who had worked for 15 years in a green tea factory, was referred for abnormal chest X-ray shadows with cough and breathlessness over a 2-month period. The chest X-ray and high-resolution computed tomography showed diffuse bilateral ground-glass opacities and poorly defined centrilobular nodules. Histopathological
examination of the thoracoscopic lung biopsy specimens showed
bronchiolocentric interstitial pneumonia with well-formed granulomas. Although the form of granulomas were atypical, laboratory data, CT findings, and intradermal skin testing suggested the diagnosis of subacute HP caused by green tea. After transfer to a different department, her condition improved markedly. Taking a precise medical history and avoidance of the suspected environmental agent proved useful in diagnosing
this condition.

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