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July 26, 1965


JAMA. 1965;193(4):302. doi:10.1001/jama.1965.03090040046015

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Pulmonary granulomas have long been associated with chronic inhalation of silica, asbestos, and beryllium. More recently, interstitial pulmonary granulomas have been seen with considerable frequency in a group of acute febrile illnesses which follow the inhalation of organic dusts. Included among these are farmers' lung, bagassosis, maplebark-strippers' disease, and mushroom-pickers' disease. Because the acute episodes closely follow exposure to the specific offending agent, and only a minority of exposed individuals are affected, an allergic etiology has been suggested. The demonstration of circulating antibodies in these diseases supports this hypothesis. The fact that these diseases are granulomatous in nature has aroused renewed interest in Germuth's studies on the experimental production of granulomas in rabbits with soluble antigens.

Pigeon-breeders' disease, reported elsewhere in this issue (p 261), is the most recent of these "hypersensitivity" lung diseases. Like the others, it is characterized by acute febrile episodes following the exposure to pigeons or

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