Farmer's Lung Medication
- Author: Laurianne G Wild, MD, FAAAAI; Chief Editor: Zab Mosenifar, MD more...
Medication Summary
Systemic corticosteroids (combined with avoidance measures) are the primary agents used to treat farmer's lung.
Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, cromolyn, nedocromil) or systemic immune modulators are not indicated for treatment at this time.
Corticosteroids
Class Summary
Have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli.
Prednisone (Deltasone, Orasone, Meticorten)
Immunosuppressant for treatment of autoimmune disorders; may decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. Prescribed for severe symptoms or significant lung dysfunction despite antigen avoidance.
Ramazzini B, Wright WC, ed. De Morbis Artificium [Diseases of Workers]. New York, NY: Hafner Publishing; 1964.
Lehrer SB, Turer E, Weill H, Salvaggio JE. Elimination of bagassosis in Louisiana paper manufacturing plant workers. Clin Allergy. Jan 1978;8(1):15-20. [Medline].
Ashitani J, Kyoraku Y, Yanagi S, Matsumoto N, Nakazato M. Elevated levels of beta-D-glucan in bronchoalveolar lavage fluid in patients with farmer's lung in Miyazaki, Japan. Respiration. 2008;75(2):182-8. [Medline].
Deschênes D, Provencher S, Cormier Y. Farmer's Lung-Induced Hypersensitivity Pneumonitis Complicated by Shock. Respir Care. Oct 12 2011;[Medline].
Bellanger AP, Reboux G, Botterel F, Candido C, Roussel S, Rognon B, et al. New evidence of the involvement of Lichtheimia corymbifera in farmer's lung disease. Med Mycol. Nov 2010;48(7):981-7. [Medline].
Hanak V, Golbin JM, Ryu JH. Causes and presenting features in 85 consecutive patients with hypersensitivity pneumonitis. Mayo Clin Proc. Jul 2007;82(7):812-6. [Medline].
Depierre A, Dalphin JC, Pernet D, Dubiez A, Faucompré C, Breton JL. Epidemiological study of farmer's lung in five districts of the French Doubs province. Thorax. Jun 1988;43(6):429-35. [Medline].
Malmberg P, Rask-Andersen A, Palmgren U, Höglund S, Kolmodin-Hedman B, Stålenheim G. Exposure to microorganisms, febrile and airway-obstructive symptoms, immune status and lung function of Swedish farmers. Scand J Work Environ Health. Aug 1985;11(4):287-93. [Medline].
Kokkarinen J, Tukiainen H, Terho EO. Mortality due to farmer's lung in Finland. Chest. Aug 1994;106(2):509-12. [Medline].
Arya A, Roychoudhury K, Bredin CP. Farmer's lung is now in decline. Ir Med J. Jul-Aug 2006;99(7):203-5. [Medline].
Cormier Y, Bélanger J. The fluctuant nature of precipitating antibodies in dairy farmers. Thorax. Jun 1989;44(6):469-73. [Medline].
Arshad M, Braun SR, Sunderrajan EV. Severe hypoxemia in farmer's lung disease with normal findings on chest roentgenogram. Chest. Feb 1987;91(2):274-5. [Medline].
Mönkäre S, Ikonen M, Haahtela T. Radiologic findings in farmer's lung. Prognosis and correlation to lung function. Chest. Apr 1985;87(4):460-6. [Medline].
Cormier Y, Brown M, Worthy S, Racine G, Müller NL. High-resolution computed tomographic characteristics in acute farmer's lung and in its follow-up. Eur Respir J. Jul 2000;16(1):56-60. [Medline].
Roussel S, Reboux G, Dalphin JC, Laplante JJ, Piarroux R. Evaluation of salting as a hay preservative against farmer's lung disease agents. Ann Agric Environ Med. 2005;12(2):217-21. [Medline].
Barbee RA, Callies Q, Dickie HA, Rankin J. The long-term prognosis in farmer's lung. Am Rev Respir Dis. Feb 1968;97(2):223-31. [Medline].
Ohtsuka Y, Munakata M, Tanimura K, Ukita H, Kusaka H, Masaki Y, et al. Smoking promotes insidious and chronic farmer's lung disease, and deteriorates the clinical outcome. Intern Med. Oct 1995;34(10):966-71. [Medline].
Thorshauge H, Fallesen I, Ostergaard PA. Farmer's lung in infants and small children. Allergy. Feb 1989;44(2):152-5. [Medline].
Lacasse Y, Fraser RS, Fournier M, Cormier Y. Diagnostic accuracy of transbronchial biopsy in acute farmer's lung disease. Chest. Dec 1997;112(6):1459-65. [Medline].
Takahashi T, Munakata M, Ohtsuka Y, Satoh-Kamachi A, Sato R, Homma Y, et al. Serum KL-6 concentrations in dairy farmers. Chest. Aug 2000;118(2):445-50. [Medline].
Nakagawa-Yoshida K, Ando M, Etches RI, Dosman JA. Fatal cases of farmer's lung in a Canadian family. Probable new antigens, Penicillium brevicompactum and P olivicolor. Chest. Jan 1997;111(1):245-8. [Medline].
Imai K, Ashitani J, Imazu Y, Yanagi S, Sano A, Tokojima M, et al. [Farmer's lung cases of a farmer and his son with high BAL fluid beta-D glucan levels]. Nihon Kokyuki Gakkai Zasshi. Dec 2004;42(12):1024-9. [Medline].
Ando M, Suga M. Hypersensitivity pneumonitis. Curr Opin Pulm Med. Sep 1997;3(5):391-5. [Medline].
Bouchard S, Morin F, Bédard G, Gauthier J, Paradis J, Cormier Y. Farmer's lung and variables related to the decision to quit farming. Am J Respir Crit Care Med. Sep 1995;152(3):997-1002. [Medline].
Cormier Y, Bélanger J. Long-term physiologic outcome after acute farmer's lung. Chest. Jun 1985;87(6):796-800. [Medline].
Emanuel DA, Kryda MJ. Farmer's lung disease. Clin Rev Allergy. Dec 1983;1(4):509-32. [Medline].
Fink JN. Hypersensitivity pneumonitis. In: Allergy Principles and Practice. 5th ed. St. Louis, Mo: Mosby; 1998:994-1004.
Fink JN. Hypersensitivity pneumonitis. Clin Chest Med. Jun 1992;13(2):303-9. [Medline].
Fraser RG, Pare JA. Diagnosis of Diseases of the Chest. 3rd ed. Philadelphia, Pa: WB Saunders; 1989:1273-90.
Gay J, Donham KJ, Leonard S. Iowa Agricultural Health and Safety Service Project. Am J Ind Med. 1990;18(4):385-9. [Medline].
Kaltreider HB. Hypersensitivity pneumonitis. West J Med. Nov 1993;159(5):570-8. [Medline].
Kline JN, Schwartz DA. Agricultural dust-induced lung disease. In: Rom WN, ed. Environmental Occupational Medicine. Philadelphia, Pa: Lippincott Raven; 1998:565-71.
Kokkarinen JI, Tukiainen HO, Terho EO. Recovery of pulmonary function in farmer's lung. A five-year follow-up study. Am Rev Respir Dis. Apr 1993;147(4):793-6. [Medline].
Lalancette M, Carrier G, Laviolette M, Ferland S, Rodrique J, Bégin R, et al. Farmer's lung. Long-term outcome and lack of predictive value of bronchoalveolar lavage fibrosing factors. Am Rev Respir Dis. Jul 1993;148(1):216-21. [Medline].
Myers ML. Health problems and disease patterns in agriculture. In: Encyclopedia of Occupational Health Safety. Geneva, Switzerland: International Labour Office; 1997.
Patel AM, Ryu JH, Reed CE. Hypersensitivity pneumonitis: current concepts and future questions. J Allergy Clin Immunol. Nov 2001;108(5):661-70. [Medline].
Patterson R, Greenberger PA, Castile RG, et al. Diagnostic problems in hypersensitivity lung disease. Allergy Proc. Mar-Apr 1989;10(2):141-7. [Medline].
Salvaggio JE. Extrinsic allergic alveolitis (hypersensitivity pneumonitis): past, present and future. Clin Exp Allergy. May 1997;27 Suppl 1:18-25. [Medline].
Schuyler M, Cormier Y. The diagnosis of hypersensitivity pneumonitis. Chest. Mar 1997;111(3):534-6. [Medline].
Schuyler M, Gott K, Edwards B. Experimental hypersensitivity pneumonitis: cellular requirements. Clin Exp Immunol. Jul 1996;105(1):169-75. [Medline].
Wiatr E, Radzikowska E, Pawlowski J. [Pulmonary fibrosis in young patients with hypersensitivity pneumonitis]. Pneumonol Alergol Pol. 2004;72(3-4):111-6. [Medline].
Wild LG. Hypersensitivity pneumonitis: A childhood disease?. Pediatr Asth Allergy. 2000;14:57-75.
Wild LG, Lopez M. Hypersensitivity pneumonitis: a comprehensive review. J Investig Allergol Clin Immunol. 2001;11(1):3-15. [Medline].

