Allergic alveolitis or hypersensitivity pneumonitis – the defeat of the respiratory system, developing upon contact with an allergen organic or inorganic origin. Target organs are the bronchi and alveoli of the system. According to ICD No. 10 disease code assigned pneumonitis J67 hypersensitivity
The causes of the disease
The reason of development of pathological process is the contact with the allergen. This so-called organic or inorganic dust, which gets into the respiratory system during the natural process of respiration.
Causes a hypersensitivity reaction following representatives of the world:
- actinomycetes – the smallest fungi and their spores;
- wood dust;
- pet hair;
- protein antigens house dust, excrement of birds, feathers;
- various nutritional agents;
- medicines both system-wide and local action.
In medical terminology describes a number of diseases associated with respirable size particles, and a specific reaction of the organism to the pathogen. A typical example is the “farmer’s lungs” or “lungs lover of birds”.
Changes in the lungs depend on the severity of hypersensitivity reactions – from inflammation to the appearance of fibrous strands. In acute course of the disease a change in the structure of the alveoli, walls of capillaries, the appearance of infiltration, vasculitis, petechial hemorrhages.
Allergic alveolitis develops as a result of sensitization and subsequent hypersensitivity reaction to the allergen. Typical symptoms are cough, shortness of breath, expectoration of sputum and weakness.
From the beginning of the pathogenic process before the first signs of damage to the respiratory system may take more than one month, and even year. The severity of symptoms depends on the severity of the lesions are acute, subacute or chronic.
In acute course of the reaction to the allergen develops within 4-8 hours. In this case there is:
- the temperature increase up to critical values.
- pain and heaviness in the chest;
- nausea, vomiting;
- weight loss until anorexia;
- during the examination of audible wheezing in the lungs, but with no noisy breathing.
The chronic form of the disease develops with prolonged contact with minor doses of the allergen. A characteristic symptom of the disease is the appearance of shortness of breath after physical exertion, cough with sputum, weakness and weight loss. The whole of the symptomatology develops gradually – from several months to several years.
Form of subacute alveolitis progressing in a few weeks or similar with exacerbation of chronic process. The patient concerned about the cough, shortness of breath, weight loss without changing the food habits.
Diagnosis of the disease
Initially you should contact the pulmonologist. If you suspect an allergic nature of the disease will need to consult an allergist. Diagnosis begins with fizikalna exploring and collecting history.
The survey shows the assignment of the following procedures:
- Chest CT for evaluating parenchymal changes in allergic alveolitis. In the images is determined by many nodules with fuzzy contours, reducing the volume of the lungs, signs of lack of oxygen.
- A chest x-ray – in most cases, the survey results did not reveal a visual of pathological changes in tissues of the lung. This is typical of acute and subacute forms of the disease. In the chronic phase in the images is determined by lung volume reduction, appear lesions.
- Bronchoscopy with a fence biopsy, broncho-alveolar lavage – the washing waters elevated levels of eosinophils and neutrophils.
Laboratory diagnosis will confirm the allergic nature of the disease. Shows the following analyses:
It is important
During the differential diagnosis necessary to exclude cancer of the respiratory system, tuberculosis, sarcoidosis and other fibrosarcoma alveolitis, aspergillosis.
Treatment of allergic alveolitis complex. An important condition of treatment is elimination of allergens. If you eliminate pathogenic organic or inorganic dust fails, it is necessary to reduce its concentration, improve ventilation, regular cleaning.
Acute process stoped with the help of corticosteroids. The most commonly used drugs prednisone. Start with high doses for 2 weeks. Then reduce the dosage and gradually carried out the abolition of the drug. Savings of prednisone does not have.
The mild form of allergic alveolitis treatment is not required. Enough eliminating contact with the allergen.
Prevention and prognosis
Specific preventive measures when pneumonitis hypersensitivity does not exist. The patient was recommended to the exclusion of contacts with potential or actual allergen and hygiene cleaning and ventilation.
If the disease is caused by professional activity, it is recommended to change his occupation.
The prognosis of the disease depends on the degree of changes in the tissues of the lungs. For acute and chronic process problems are reversible with proper treatment and lack of contact with the pathogen. If the lungs were formed of fibrous strands, the prognosis depends on the degree of the degeneration of the tissues. But in the absence of contact with the allergen status of the respiratory system to normal.
After repeated episodes of allergic alveolitis of nature and the development of complications of the heart the prognosis is poor.
Latin Alexander, doctor of medicine Explorer