Hypersensitivity Pneumonitis Due to Lentil Aspiration in Children: A Case Series

Abstract Hypersensitivity pneumonitis (HP) in children is a common cause of interstitial lung disease. HP has been seen in the patient due to the inhalation of different bacteria, fungi, and other particles, such as feathers of various types of birds. In our study, we observed that children who were forced to feed themselves with lentil-based weaning food had respiratory symptoms and radiology similar to HP. Here, we are reporting nine patients admitted over 13 months with symptoms of persistent cough, breathing difficulty, not responding to antibiotics, and persistent radiological changes in chest radiographs and computerized tomography. The median age of the cases was 12 months, with male predominance. Flexible bronchoscopy was done to rule out any structural anomalies in the airways and to obtain broncho-alveolar lavage, which yielded no results for pyogenic and tubercular infections. The immunoglobulin G (IgG) specific for lentils ranges from 17.6 to > 200 mgA/L. All children received oral steroids for up to 8 weeks and showed remarkable improvement in clinical and radiological status. In conclusion, lentil-induced HP in infants during weaning should be considered in cases with persistent cough and non-resolving pneumonia.