scholarly journals Spotlight on the diagnosis of extrinsic allergic alveolitis (hypersensitivity pneumonitis)

Author(s):  
Xaver Baur ◽  
Axel Fischer ◽  
Lygia T Budnik
PEDIATRICS ◽  
1987 ◽  
Vol 79 (6) ◽  
pp. 1027-1029
Author(s):  
STEPHEN J. WOLF ◽  
ALLAN STILLERMAN ◽  
MILES WEINBERGER ◽  
WILBUR SMITH

Chronic interstitial lung disease is an uncommon clinical entity in childhood. The onset is frequently insidious with progressive tachypnea, dyspnea, cyanosis, clubbing, weight loss, and hypoxia. More than 100 different occupational and environmental agents have been identified as causes, although two thirds of cases are reported as idiopathic.1 Assessment can involve invasive procedures such as bronchoalveolar lavage and open lung biopsy. Treatment of the idiopathic forms includes use of corticostenoids and cytotoxic agents, and response is variable with progression to pulmonary fibrosis being a common end stage. In contrast to this grim prognosis, the similar clinical pattern associated with hypersensitivity pneumonitis, also identified as "extrinsic allergic alveolitis," can be rapidly reversed if the offending antigen is identified and eliminated.


2020 ◽  
Vol 71 (1) ◽  
pp. 69-73
Author(s):  
Smărăndescu Raluca Andreea ◽  
Mircea-Constantin Diaconu ◽  
Claudia-Mariana Handra ◽  
Agripina Rașcu

AbstractHypersensitivity pneumonitis is a group of inflammatory interstitial lung diseases caused by hypersensitivity immune reactions to the inhalation of various antigens: fungal, bacterial, animal protein, or chemical sources, finely dispersed, with aerodynamic diameter <5μ, representing the respirable fraction. The national register for interstitial lung diseases records very few cases of hypersensitivity pneumonitis (extrinsec allergic alveolitis), a well defined occupational disease. Although not an eminently of occupational origin, the extrinsec allergic alveolitis can occur secondary to occupational exposure to organic substances (animal or insect proteins, bacteria, fungi) or inorganic (low molecular weight chemical compounds) and the occupational doctor is a key actor in the diagnosys. The disease has chronic evolution and exposure avoidance, as early as possible, has major prognostic influence. The occupational anamnesis remains the most important step and the occupational physician is the one in charge for monitoring and detection of the presence of respiratory symptoms in all employees with risk exposure. Next, we present the case of a farmer, without other comorbidities, who develops various respiratory and systemic diseases and manifestations due to repeated exposure to animal proteins and molds, in order to review the risk factors and the consequences of exposure in poultry farms.


2019 ◽  
Vol 12 (12) ◽  
pp. e230724 ◽  
Author(s):  
Gursharan Virdee ◽  
John Bleasdale ◽  
Mohammed Ikramullah ◽  
Emma Graham-Clarke

Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, is a granulomatous, non-IgE-mediated hypersensitivity reaction of the alveoli and distal bronchioles presenting as an acute, subacute or chronic condition. It is most commonly associated with exposure to extrinsic allergens (eg, avian dust, mould and tobacco) and medications including antiarrhythmics (eg, amiodarone), cytotoxics (eg, methotrexate) and antiepileptics (eg, carbamazepine). Individuals diagnosed with this condition can present with severe hypoxia and respiratory failure. The fundamental principle of management is to remove the causative allergen. Evidence implicating selective serotonin reuptake inhibitors as a causative agent is limited, and this case report describes a rare clinical presentation of HP associated with sertraline, how it was diagnosed and subsequently treated. It is anticipated that raising awareness of this interaction will assist multidisciplinary teams, managing patients diagnosed with HP, to be more cognisant of sertraline as being an aetiological factor for this condition.


Asthma ◽  
2014 ◽  
pp. 3-11
Author(s):  
David I. Bernstein

Hypersensitivity pneumonitis (HP), also referred to as extrinsic allergic alveolitis, is an allergic inflammatory parenchymal lung disease usually caused by inhalational exposure to organic antigens from microbial bioaerosols or animal sources encountered in the work or home environment. Patients with HP can present with wheezing and obstructive abnormalities leading to an incorrect asthma diagnosis. The presence of a gas exchange abnormality, bronchoalveolar lavage lymphocytosis, and characteristic infiltrative changes on high-resolution computed tomography of the chest can be used to distinguish HP from asthma. The early diagnosis of HP and cessation of exposure to causative antigens result in remission of the disease and no residual impairment.


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