Hypersensitivity pneumonitis as a cause of airway-centered interstitial fibrosis

Background: Airway-centered interstitial fibrosis (ACIF) has been postulated to be related to environmental exposures. Objective: To describe a patient with ACIF associated with hypersensitivity pneumonitis. Methods: We evaluated a patient with a 2-year history of progressive dyspnea and exercise intolerance. We performed computed tomography, pulmonary function tests, and skin prick tests. Results : The patient's computed tomogram suggested hypersensitivity pneumonitis. Pulmonary function testing demonstrated a restrictive pattern. Results of skin prick tests to chicken, goose, canary, and budgie were negative. However, serum precipitins were positive to serum from pigeon, goose, duck, and chicken feathers. The patient was diagnosed as having ACIF. Conclusion: We believe that ACIF may represent a final common pathway for lung injury due to environmental exposure.