Extrinsic allergic alveolitis – rarely diagnoticated disease

Česká verzia

Authors: D. Lauková; I. Marget; J. Plutinský
Authors place of work: II. oddelenie pneumológie a ftizeológie Špecializovanej nemocnice sv. Svorada Zobor, n. o., Nitra, Slovenská republika, prednosta doc. MUDr. Ján Plutinský, CSc.
Published in the journal: Vnitř Lék 2009; 55(5): 489-500
Category: Reviews

Summary

Extrinsic allergic alveolitis (EAA), known as hypersensitive pneumonitis, causes interstitial lung involvement by inhaled antigen. The clinical presentation of the disease has been defined as acute, subacute and chronic. The most often symptoms of the acute form of the disease are flu‑like symptoms, dyspnoe and cough. The progressive dyspnoe in particullary is characterized for the chronic form of EAA. Dyspnoe is worsed, if the disease is combinied with usual respiratory infection or reexposition of inhaled antigen. It seems the diagnostic definition of EAA should be easy and prevalence of EAA relative high. The disease belongs to the group of interstitial lung diseases and it is underestimated as a matter of fact. The clinic, radiographic, laboratory and histologic abnormalities are results of inhaled antigen contact and support the diagnosis of EAA. Specific IgG antibodies against the offending antigen along with them are consedered to be detected (established) of EAA.

Key words:
extrinsic allergic alveolitis – forms of EAA – clinic symptoms – diagnostic methods – treatment

Zdroje

1. Costabel V, du Bois RM, Egan JJ et al. Hypersensitivity Pneumonitis. In: Diffuse Parenchymal Lung Disease. Costabel V, du Bois RM, Egan JJ et al (eds). Prog Respir Res. Basel, Karger 2007: 139–147.

2. Šterclová M, Vašáková M. Exogenní alergická alveolitida. Popelka mezi intersticiálními plicními procesy? Prakt Lék 2007; 87: 470–473.

3. Bertonelli G, Bocchino V, Oliveri D. Hypersensitivity pneumonitis. Interstitial lung diseases. Eur Respir Monograph 2000; 14: 120–136.

4. Sennekamp J, Müller-Wening D, Amthor M et al. Empfehlungen zur Diagnostik der exogen-allergischen Alveolitis. Pneumologie 2007; 61: 52–56.

5. Kurup VP, Zacharisen MC, Fink JN. Hypersensitivity pneumonitis. Indian J Chest Dis Allied Sci 2006; 48: 115–128.

6. Hurbánková M. Niektoré nové poznatky v oblasti profesionálnej prašnej expozície a pľúcnych ochorení. I. Vláknité prachy. Stud Pneumol Phtiseol 1999; 59: 99–103.

7. Plutinský J, Moczová J, Magula D et al. Pilot study of quantitative computer tomography of lung and number of CD4+ and CD8+ in patients with sarcoidosis. Eur Resp J 2003; 22 (Suppl 45): 247.

8. Votava V. Exogenní alergická alveolitida. In: Homolka J, Votava V (eds). Intersticiální plicní procesy. Praha: Maxdorf 1999; 65–72.

9. Minárik L, Pokorná V, Votrubová V et al. Exogénne alergické alveolitídy pozorované v OLÚ TaRCH vo Vyšných Hágoch za posledných 10 rokov. Stud Pneumol Phtiseol Cechoslov 1986; 46: 11–17 .

10. Vyšehradský R, Strapko P, Straková J et al. Akútna exacerbácia „farmárskych pľúc“ v zime v meste. Kazuistiky v pneumológii 2006; 3: 9–14.

11. Majer I, Novosadová H, Chovan L. Bronchoalveolárna laváž a jej postavenie v diagnostike pľúcnych ochorení. Respiro 2006; 5: 6–12.

12. Meřička O. Kortikoterapie u exogenní alergické alveolitis. Stud Pneumol Phtiseol Cechoslov 1984; 44: 195–199.

13. Moczová J, Rin‑Müller R, Ševčíková Ľ et al. Kvantitatívna histologizácia. Analýza pľúc pomocou HRCT v diagnostike granulomatóz. Slov Radiol 2001; 1: 51.

14. Ohtami Y, Saiki S, Kitaichi M et al. Chronic bird fancier’s lung: histopathological and clinical correlation. Thorax 2005; 60: 665–671.

15. Ohtami Y, Saiki S, Sumi Y et al. Clinical features of reccurent and insidious chronic bird fancier’s lung. Ann Allergy Asthma Immunol 2003; 90: 604–610.

16. Drent M, Jacobs JA, Wagenaar AS. Bronchoalveolar lavage. Eur Respir Mon 2000; 14: 63–78.

17. Miyagawa T, Hamagami S, Tanigawa T. Cryptococcus albidus‑induced Summer type Hypersensitivity Pneumonitis. Am J Respir Crit Care Med 2000; 161: 961–966.

18. Westhoff M, Welim B, Müller KM. Bronchozentrische Granulomatose. Pneumologie 2005; 59: 804–810.

19. Sennekamp J, Joest M. Exogen-allergische Alveolitis-neue Erkentnisse. Pneumologie 2008; 62: 51–54.

20. Koschel D. Exogen-allergische Alveolitis. Pneumologie 2007; 61: 305–332.

21. Westhoff M, Welim B, Müller KM. Bronchozentrische Granulomatose. Pneumologie 2005; 59: 804–810.

22. Lau S. Kompendium Pneumologie. 1 Jahrg. 2007; 1: 20–21.

23. Tobas D, Aubert D, Villena I et al. Use of co-immunoelectrodiffusion to detect presumed disease-asociated precipitating antibodies, and time-course value of specific isotypes in bird-breeder’s disease. Jour Immunol Met 2003; 272: 135–145.

24. Baur X. Hypersensitivity pneumonitis (extrinsic allergic alveolitis) induced by isocyanates. J Allergy Clin Immunol 1995; 95: 197–205.

25. Vandenplas O, Leveque J, Cartier A et al. Hypersensitivity pneumonitis‑like reaction among workers exposed to diphenylmethane diisocyanate (MDI). Am Rev Respir 1993; 174: 338–346.

26. Depierre A, Dalphin JC, Pernet D et al. Epidemiological study of farmer’s lung in five districts of the French Doubs province. Thorax 1988; 43: 429–435.

27. Malmberg P, Rask A et al. Incidence of organic dust toxic syndrome and allergic alveolitis in Swedish farmers. Int Arch Allergy Appl Immunol 1988; 87: 47–54.

28. Terho EO, Heinonen OP, Lami S. Incidence of farmer’s lung leading to hospitalisation and its relation to meteorological observations in Finland. Acta Med Scan 1983; 213: 295–298.

29. Lodha S, Maria S, Sharma OP. Hypersensitivity pneumonitis in a saxophone player. Chest 1988; 93: 1322.

30. Metzer WJ, Patterson R, Fink J et al. Sauna taker’s disease. JAMA 1976; 236: 2209–2211.

31. Bourke SJ, Dalphin JC, Boyd G et al. Hypersensitivity pneumonitis: current concepts. Eur Respir J 2001; 18 (Suppl 32): 81–92.

32. Hendrick DJ, Faux JA, Marshall R. Budgerigar fancier’s lung: the commonest variety of allergic alveolitis in Britain. BMJ 1978; 1: 81–84.

33. De Castro FR, Carrillo T, Castillo R et al. Relationships between characteristics of exposure to pigeon antigens, clinical manifestations and humoral immune response. Chest 1993; 103: 1059–1063.

34. Ando M, Hirayama K, Soda K et al. HLA‑ DQw3 in Japanese summer type hypersensitivity pneumonitis induced by Trichosporon cutaneum. Am rev Respir Dis 1989; 140: 948–950.

35. Selman M, Teran L, Mendosa A et al. Increase of HLA‑DR7 in pigeon breeder’s lung in a Mexican population. Clin Immunol Immunopathology 1987; 44: 63–70.

36. Flaherty DK, Iha T, Chmelik F et al. HLA‑B8 in farmer’s lung. Lancet 1975; 2: 507.

37. Rittner C, Sennekamp J, Vogel F. HLA‑B8 in pigeon fancier’s lung. Lancet 1975; 2: 1303.

38. Dalphin JC, Debieuvre D, Penet D et al. Prevalence and risk factors for chronic bronchitis and farmer’s lung in French dairy farmers. Br J Ind Med 1993; 50: 941–944.

39. Mc Sharry C, Lynch PP, Banham SW et al. Seasonal variation of antibody levels among pigeon fanciers. Clin Allergy 1983; 13: 293–299.

40. Lauková D, Marget I, Plutinský J et al. Exogénna alergická alveolitída – dokážeme ju včas rozpoznať? XIV. kongres ČaSPFS, Bardejov, 12.–15. 6. 2008.