Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1968 Sep;23(5):451–468. doi: 10.1136/thx.23.5.451

Farmer's lung

A clinical, radiographic, functional, and serological correlation of acute and chronic stages

E J Hapke 1, R M E Seal 1, G O Thomas 1, M Hayes 1, J C Meek 1
PMCID: PMC471821  PMID: 4971361

Abstract

In assessing patients suffering from farmer's lung, the acute stage must be distinguished from the chronic stage of the disease. The conspicuous radiographic signs in the acute farmer's lung episode and the often dramatic clearing make an important contribution to the diagnosis. The radiographic changes in chronic farmer's lung are not specific and cover a wide range of appearances. Even minor nodular changes are significant. Farmer's lung, acute and chronic, is not a disease predominantly characterized by a defect in gas exchange. During the acute illness the reduction in diffusing capacity is often accompanied by a decrease in lung volumes; the pulmonary function profile of the chronic stage is variable. In only a relatively small proportion of chronic farmer's lung patients does a defect in gas exchange predominate, and in some it may be manifest only during exercise. Airway obstruction is a feature of chronic farmer's lung. In chronic farmer's lung patients discrepancies between the severity of complaints and results of pulmonary function tests are not infrequent. In some patients with considerable disability conventional pulmonary function studies may demonstrate little or no impairment of the functions measured. In patients suffering from an acute farmer's lung episode, serological tests should be positive, possibly in high titre. In the chronic stage of the disease the chance of finding positive serology in a patient diminishes with the length of time elapsed since the last acute episode. The period of serological transition appears to be the third year.

Full text

PDF
466

Images in this article

455Image
on p.455
455Image
on p.455
456Image
on p.456
456Image
on p.456
457Image
on p.457

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BISHOP J. M., MELNICK S. C., RAINE J. FARMER'S LUNG: STUDIES OF PULMONARY FUNCTION AND AETIOLOGY. Q J Med. 1963 Jul;32:257–278. [PubMed] [Google Scholar]
  2. BLAKEMORE W. S., FORSTER R. E., MORTON J. W., OGILVIE C. M. A standardized breath holding technique for the clinical measurement of the diffusing capacity of the lung for carbon monoxide. J Clin Invest. 1957 Jan;36(1 Pt 1):1–17. doi: 10.1172/JCI103402. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. DICKIE H. A., RANKIN J. Farmer's lung; an acute granulomatous interstitial pneumonitis occurring in agricultural workers. J Am Med Assoc. 1958 Jun 28;167(9):1069–1076. doi: 10.1001/jama.1958.02990260011004. [DOI] [PubMed] [Google Scholar]
  4. DOLL R., HILL A. B. Smoking and carcinoma of the lung; preliminary report. Br Med J. 1950 Sep 30;2(4682):739–748. doi: 10.1136/bmj.2.4682.739. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. EMANUEL D. A., WENZEL F. J., BOWERMAN C. I., LAWTON B. R. FARMER'S LUNG: CLINICAL, PATHOLOGIC AND IMMUNOLOGIC STUDY OF TWENTY-FOUR PATIENTS. Am J Med. 1964 Sep;37:392–401. doi: 10.1016/0002-9343(64)90195-0. [DOI] [PubMed] [Google Scholar]
  6. FRY D. L., STEAD W. W., EBERT R. V., LUBIN R. I., WELLS H. S. The measurement of intraesophageal pressure and its relationship to intrathoracic pressure. J Lab Clin Med. 1952 Nov;40(5):664–673. [PubMed] [Google Scholar]
  7. FULLER C. J. Farmer's lung: a review of present knowledge. Thorax. 1953 Mar;8(1):59–64. doi: 10.1136/thx.8.1.59. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. GRABAR P., WILLIAMS C. A. Méthode permettant l'étude conjuguée des proprietés électrophorétiques et immunochimiques d'un mélange de protéines; application au sérum sanguin. Biochim Biophys Acta. 1953 Jan;10(1):193–194. doi: 10.1016/0006-3002(53)90233-9. [DOI] [PubMed] [Google Scholar]
  9. HIGGINS I. T. Tobacco smoking, respiratory symptoms, and ventilatory capacity; studies in random samples of the population. Br Med J. 1959 Feb 7;1(5118):325–329. doi: 10.1136/bmj.1.5118.325. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. JOHNSON R. L., Jr, SPICER W. S., BISHOP J. M., FORSTER R. E. Pulmonary capillary blood volume, flow and diffusing capacity during exercise. J Appl Physiol. 1960 Sep;15:893–902. doi: 10.1152/jappl.1960.15.5.893. [DOI] [PubMed] [Google Scholar]
  11. JOHNSON R. L., Jr, TAYLOR H. F., LAWSON W. H., Jr MAXIMAL DIFFUSING CAPACITY OF THE LUNG FOR CARBON MONOXIDE. J Clin Invest. 1965 Mar;44:349–355. doi: 10.1172/JCI105148. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. KOBAYASHI M., STAHMANN M. A., RANKIN J., DICKIE H. A. Antigens in moldy hay as the cause of farmer's lung. Proc Soc Exp Biol Med. 1963 Jun;113:472–476. doi: 10.3181/00379727-113-28400. [DOI] [PubMed] [Google Scholar]
  13. MARSHALL R. The physical properties of the lungs in relation to the subdivisions of lung volume. Clin Sci. 1957 Aug;16(3):507–515. [PubMed] [Google Scholar]
  14. NEEDHAM C. D., ROGAN M. C., McDONALD I. Normal standards for lung volumes, intrapulmonary gas-mixing, and maximum breathing capacity. Thorax. 1954 Dec;9(4):313–325. doi: 10.1136/thx.9.4.313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. PEPYS J., JENKINS P. A. PRECIPITIN (F.L.H.) TEST IN FARMER'S LUNG. Thorax. 1965 Jan;20:21–35. doi: 10.1136/thx.20.1.21. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. RANKIN J., JAESCHKE W. H., CALLIES Q. C., DICKIE H. A. Farmer's lung: physiopathologic features of the acute interstitial granulomatous pneumonitis of agricultural workers. Ann Intern Med. 1962 Oct;57:606–626. doi: 10.7326/0003-4819-57-4-606. [DOI] [PubMed] [Google Scholar]
  17. Seal R. M., Hapke E. J., Thomas G. O., Meek J. C., Hayes M. The pathology of the acute and chronic stages of farmer's lung. Thorax. 1968 Sep;23(5):469–489. doi: 10.1136/thx.23.5.469. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Staines F. H., Forman J. A. A Survey of " Farmer's Lung ". J Coll Gen Pract. 1961 Aug;4(3):351–382. [PMC free article] [PubMed] [Google Scholar]
  19. WILLIAMS J. V. Inhalation and skin tests with extracts of hay and fungi in patients with farmer's lung. Thorax. 1963 Jun;18:182–196. doi: 10.1136/thx.18.2.182. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES