Hypersensitivity pneumonitis presenting as sarcoidosis.

Pulmonary sarcoidosis and hypersensitivity pneumonitis are two disease entities that may have similar clinical, laboratory, and pathological features. A low index of suspicion for hypersensitivity pneumonitis combined with the overlapping features contribute to the difficulty of distinguishing the two diseases. Indeed, two case series suggest that four of 51 and two of 46 subjects originally diagnosed as having sarcoidosis showed clinical and histological characteristics more consistent with hypersensitivity pneumonitis.1 2 Because early recognition of hypersensitivity pneumonitis can lead to complete reversal of disease in many cases, it is important to make this diagnosis as early as possible. We present a case that was most likely misdiagnosed and resulted in continued workplace exposure, considerable morbidity, and unwarranted discharge from employment due to a probable work related illness.