Calcified Granulomatous Disease: Occupational Associations and Lack of Familial Aggregation
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The acute host response to histoplasma capsulatum infection varies according to exposure and susceptibility. Late sequelae include calcifications in the lung, thoracic lymphatics, and spleen. Determinants of calcified granuloma formation are poorly studied and may differ from those affecting acute response. We examined the occupational associations and familial aggregation of radiographic calcified granulomatous disease to characterize the determinants of calcified granuloma formation.
We analyzed prospectively collected cross-sectional data including computed tomograms from 872 adult members of the Old Order Amish of Lancaster County.
Granulomas were present in 71 % of participants. Granulomas were present in the lung of 57 % of participants, in the hilar or mediastinal lymph nodes of 55 % of participants, and in the spleen of 29 % of participants. No significant differences were observed in the presence of granulomas between men and women. Each year of age was associated with 4 % higher odds of splenic calcifications, and a primary occupation of farming was associated with an 84 % higher odds of splenic calcifications. A compelling pattern of familial aggregation was not observed.
Calcified granulomatous disease does not appear to aggregate in families. Determinants influencing patterns of granulomatous disease include occupation, age, and geographic location.
KeywordsCalcified granuloma Occupational lung disease Farming lung disease Old Order Amish Amish Familial aggregation Histoplasma Granulomatous lung disease
Old Order Amish
Pittsburgh Lung Screening Study
This work was supported by research grants R01 HL69313 and U01 HL72515 and the University of Maryland General Clinical Research Center (Grant M01 RR 16500), General Clinical Research Centers Program, National Center for Research Resources, National Institutes of Health, and the Baltimore Veterans Administration Geriatric Research and Education Clinical Center. Dr. Reed is supported in part by the Flight Attendants Medical Research Institute. Dr. Netzer is supported in part by the Clinical Research Career Development Award from the National Institutes of Health (NIH), Bethesda, MD (5K12RR023250-03). We would like to thank Drs. David O. Wilson and Joel Weissfeld for their contribution of data from PLuSS. We would like to thank the Amish community members of Lancaster County for their ongoing participation in our studies.
Conflict of Interest
No author reports any potential conflict of interest.
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