the main
about the project
Medicine news
To the authors
Licensed books on medicine
<< Ahead Next >>

Exogenous allergic alveolites

Exogenous allergic alveolitis (synonym: hypersensitive pneumonitis, interstitial granulomatous alveolitis) is a group of diseases caused by intense and, rarely, prolonged inhalation of antigens of organic and inorganic dusts and are diffuse, unlike pulmonary eosinophilia, and alveolar and interstitial structures. The emergence of this group of diseases is associated with the development of immunocomplex (type III) and cell-mediated (type IV) allergic reactions.



Atonic IgE-dependent mechanisms are not characteristic of allergic alveolitis. The inflammatory process is localized in the alveoli and interstitium of the lungs, and not in the air-conducting paths, as in bronchial asthma, although the latter may be a concomitant disease in patients with alveolitis.



Etiological factors that can cause exogenous allergic alveolitis, can be divided into 3 groups:



1) microorganisms (bacteria, fungi, protozoa and their metabolic products (proteins, enzymes, endotoxins, etc.));



2) organic matter of animal and vegetable origin (animal dander, bird feathers, rice dust, etc.);



3) low molecular weight compounds (diisocyanite, salts of heavy metals, including gold), medications (Intal, antibiotics, nitrofurans, antimycotic drugs, antimetabolites). For the occurrence of alveolitis requires several conditions:



1) inhalation route of penetration of the antigen (the diameter of the dust particles is not more than 5 microns);



2) high concentrations of antigen in the air we breathe and significant exposure;



3) the antigen must be presented in the corpuscular form (cells) or in the form of an aggregated protein; soluble antigens do not cause the development of alveolitis;



4) the antigen must have the ability to activate the complement system along an alternative path, i.e. without antibodies.



Pathologically allergic alveolitis is characterized by damage to the alveolar and endothelial cells, vasculitis, mononuclear and (or) polynuclear infiltration of the interstitial tissue and alveolar structures of the lungs, the formation of sarcoid-like granulomas, interstitial fibrosis.



The name of the disease most often reflects the etiological factor:



“Milling lung”, “lung cheesemakers”, “poultry farmers lung”, etc.



During the course of the disease, there are acute, subacute and chronic stages (forms).



The acute form develops 4-12 hours after the patient contacts the allergen. There is flu-like syndrome: chills, fever, cough, shortness of breath, nausea, myalgia, arthralgia. Other acute forms include pneumonia-like (crepitus and moist rales on auscultation, interstitial infiltrates on X-ray) and bronchotic (dry cough, "scattered rales in the lungs) syndromes.
Neutrophilic leukocytosis is observed in the blood. In the study of respiratory function, a mixed type of respiratory failure (obstructive and restrictive) is detected. Radiologically, reticular or modular (0.1–1 cm diameter) infiltrative shadows can be detected:



Frosted glass type changes, indistinguishability of vascular pattern.



The acute form may have a progressive course with severe



the prognosis, but more often the suspension due to illness from work or hospitalization leads to an improvement in the condition. The diagnosis of the acute form of exogenous alveolitis is rarely made, usually diagnosed with influenza, acute respiratory viral infections, acute pneumonia or bronchitis.



Subacute form develops with continued contact with the antigen. In these cases, the “Monday phenomenon” is typical:



acute manifestations are observed in the days after rest, and by the end of the working week they subside.



The chronic form of exogenous allergic alveolitis is observed during long-term contact with an allergen and a long course of the disease. Pathologically, this form is based on interstitial fibrosis (“fibrosing alveolitis”), therefore the clinical manifestations of the disease are similar to the clinic of idiopathic fibrosing alveolitis (Hammen-Rich disease). In patients with respiratory failure, accompanied by asthenic syndrome, anorexia, and weight loss. A pulmonary heart develops with appropriate symptoms. X-ray examination reveals signs of pulmonary fibrosis: diffuse reticular, modular and linear shadows, symptoms of lung defrostation, a picture of the “cellular lung”. In the study of respiratory function, a restrictive type of respiratory failure is recorded.







DIAGNOSIS of exogenous allergic alveolitis is carried out on the basis of an assessment of the clinic of the disease, a thorough history taking, instrumental methods and an immunological examination. For the detection of specific antibodies, precipitation reactions, passive hemagglutination, enzyme immunoassay are used. The pagapental reaction of lymphocyte blast-transform and the inhibition of leukocyte migration with a specific antigen have a diagnostic significance.



Did not lose their value intradermal tests with a dilution of the allergen 1:10. Sometimes a lung biopsy is required.



The differential diagnosis is carried out in the acute stage with acute respiratory viral infections, influenza, acute pneumonia, acute bronchitis. In the chronic stage, the disease is differentiated from idiopathic fibrosing alveolitis and granulomatous processes in the lungs (tuberculosis, sarcoidosis, Wegener's granulomatosis, etc.) -
<< Ahead Next >>
= Go to tutorial content =

Exogenous allergic alveolites

  1. Exogenous allergic alveolitis
    This is a group of diseases caused by inhalation of organic dust, which occur with diffuse granulomatous lesions of the interstitial lung tissue. Unlike other granulomatous lesions of the lungs, such as sarcoidosis and coccidioidomycosis, there are no systemic manifestations in exogenous allergic alveolitis. Inhalation of organic dust leads to the development of exogenous allergic
  2. Allergic rhinitis, allergic conjunctivitis, urticaria, quinck edema
    Acute allergic diseases are caused by an increased sensitivity of the immune system to various exogenous antigens (allergens). They are characterized by a sudden onset, unpredictable course, high risk of developing life-threatening conditions. ETIOLOGY AND PATHOGENESIS The most frequent allergens are: ¦ food (fish, seafood, nuts, honey, milk, eggs, fruits, legumes, etc.); |
  3. Allergic diseases of the paranasal sinuses (allergic sinuitis)
    Acute and chronic allergic diseases of the paranasal sinuses are a special category of pathological conditions of the mucous membrane of the upper respiratory tract, resulting from an increased sensitivity of the patient's body to a foreign protein (antigen or allergen) and due to neurogenic and endocrine disorders. In the pathology of the disease a large role belongs
  4. Exogenous hyperthermia.
    Exogenous hyperthermia occurs when a significant increase in heat flow from the external environment: in hot climates, hot shops, with artificial increase in air temperature in the bath, etc. Cause of exogenous hyperthermia can also be factors that impede heat transfer - moisture-proof insulating clothing, high humidity, insufficient ventilation. Most rapidly exogenous
  5. Exogenous steroid withdrawal syndrome
    Appearance, resembling the appearance of a patient with Cushing's syndrome, should always be an indication for the use of exogenous corticosteroids and suppression of pituitary-adrenal connections. Adrenal insufficiency as a result of exogenous steroid therapy is surprisingly rare, given the frequency with which corticosteroids are used. Probability of development of failure
  6. Exogenous neurointoxication. GENERAL CHARACTERISTICS
    Exogenous neurointoxications are persistent or transient disorders of the nervous system, resulting from exposure to the body of toxic chemicals. Exogenous neurointoxications that develop as a result of exposure to the body of industrial poisons, subject to insufficient compliance with sanitary and hygiene and sanitary requirements, are called
  7. Syndrome of exogenous poisoning
    Poisoning (intoxication, acute overdose) - pathological conditions caused by the action of toxic substances of exogenous origin in any way they enter the body. The severity of the patient's condition in case of poisoning depends on the dose of poison, the route of its receipt, the time of exposure, the premorbid state (bleeding, hypoxia, acute cardiovascular insufficiency and others).
  8. ALLERGIC LUNG DISEASES
    In recent decades there has been a significant increase in the number. patients with allergic diseases of the bronchopulmonary apparatus. Allergic lung diseases include exogenous allergic alveolitis, pulmonary eosinophilia, medicinal
  9. EMERGENCY STATES OF EXOGENOUS GENESIS
    EMERGENCY STATES OF EXOGENOUS
  10. EMERGENCY CONDITIONS WITH EXOGENOUS PHYSICAL EXPOSURE
    EMERGENCY CONDITIONS DURING EXOGENOUS PHYSICAL
  11. Resuscitation and intensive care for acute exogenous poisoning.
    Lecture 6 OEO is a pathological process that occurs as a result of the ingress of various toxic substances from the external environment into the body that cause disturbances of homeostasis. A poisonous substance is a poison that is ingested from the outside. The severity of O. depends on the dose, concentration, rate of excretion and the route of penetration of toxic substances into the body. Toxic substances can
  12. The immune system protects the internal environment of the body from exogenous and endogenous antigens
    The immune system protects the internal environment of the body from exogenous and endogenous
  13. Diseases caused by unhealthy diet: caries, rickets, exogenous-konegguitsionno obesity, hypo-and avitaminosis, their prevention
    Violations of the sanitary standards of storage and distribution of ready meals can lead to massive gastrointestinal diseases and food poisoning. Poisoning: * Chemical - resulting from poisonous products (mushrooms, fish and shellfish, weed seeds) * Bacteriological - are caused by the consumption of infected products (meat, fish, dairy products). Most dangerous
Medical portal "MedguideBook" © 2014-2016
info@medicine-guidebook.com