HYPERSENSITIVITY PNEUMONITIS (EXOGENOUS ALLERGIC ALVEOLITIS) IN CHILDREN

А bibliographical review, based on domestic and foreign data, provides up-to-date information on hypersensitivity pneumonitis (HP, exogenous allergic alveolitis) in children. It presents the current data on epidemiology, etiology, pathogenesis, classification, clinical manifestation, diagnosis, therapy, prevention and prognosis of the disease. A computed tomographic semiotics of HP is described in full details in comparison with data on morphology and histopathological patterns of the disease. This review includes classification criteria for the disease for diagnosis of reliable, probable and possible HPs to be verified. Information on the treatment and prevention of the disease is presented in an evidence-based medicine context.

Hypersensitivity pneumonitis complicated by acute respiratory viral infection

The article presents a clinical case of hypersensitivity pneumonitis complicated by a viral infection in a 72-year-old woman. The introductory part provides a concise literature review on the etiology, classification, frequency, and possible complications of hypersensitivity pneumonitis. The patient’s computed tomography (CT) lung scan showed bilateral interstitial lesions. The patient was diagnosed with idiopathic pulmonary fibrosis based on the clinical manifestations and radiological findings. The autopsy revealed morphological signs of hypersensitivity pneumonitis (obliterative bronchiolitis, moderate interstitial fibrosis with honey-combing, nonspecific interstitial pneumonia, giant multinucleated cells) and viral lung damage (exudative stage of acute respiratory distress syndrome with interalveolar edema, hyaline membranes lining the alveoli, pneumocyte desquamation, and ugly giant cells). Keywords: hypersensitivity pneumonitis, exogenous allergic alveolitis, viral infection, lungs

Computed tomography in the diagnosis of exogenous allergic alveolitis from the exposure of industrial aerosols

Developed CTVR- criteria for the destruction of the pulmonary parenchyma in patients with exogenous allergic alveolitis from the exposure of various industrial aerosols to reveal the peculiarities of formation and course of disease. 2 groups (203 patients) with alveolitis of different etiology were examined. Comparative analysis of the results of the study showed the importance of CTVR in the diagnosis of professional alveolitis.

DIFFERENTIAL DIAGNOSTICS OF NON-SPECIFIC INTERSTITIAL PNEUMONIA

A retrospective analysis of case histories of 82 patients with nonspecific interstitial pneumonia, 24 patients with idiopathic pulmonary fibrosis, 8 with exogenous allergic alveolitis, 12 with systemic scleroderma and 6 with drug pneumonia was carried out in hospital treatment in the pulmonology department of the Samarkand city medical hospital in 2010-2019 years. It has been established that in the differential diagnosis of nonspecific interstitial pneumonia and other lung diseases, particular attention should be paid to the anamnesis, clinical presentation and CT signs

THE EXPERIENCE OF JOINT WORK OF THE CLINIC OF OCCUPATIONAL PATHOLOGY (CENTER OF OCCUPATIONAL PATHOLOGY) AND THE DEPARTMENT OF THE SCIENTIFIC SUPPORT OF SANITARY AND EPIDEMIOLOGICAL SURVEILLANCE AND EXPERTISE TO ESTABLISH THE CONNECTION OF DISEASES WITH THE OCCUPATION

Introduction. The sanitary and hygienic characteristics of the patient’s working conditions made in accordance with the current regulatory documents do not contain an unambiguous conclusion about the adequacy of the occupational risk’s degree for an unambiguous justification of the relation of the disease with the occupation. In this situation a search for new methods which could help to recognize the risk degree is urgent. Material and methods. As an example of a solution of this problem, two expert examinations are given: two patients, diagnosed adenocarcinoma of the lung and exogenous allergic alveolitis were observed in the Clinic of Occupational Pathology of North-West Public Health Research Center. The key aspect of this work was a refinement of the professional risk based on data specified in sanitary and hygienic characteristics of working conditions. The methods from the R 2.2.2006 - 05. “Guidance on hygienic assessment of working environment factors and working process. Criteria and classification of working conditions” were used. Discussion. The use of the described methodology was suggested in cases when it’s necessary to estimate the effect of the combination of unidirectional substances and carcinogens in low-dose rates by the long-term exposure. The participation of the occupational hygiene’s specialists in the expertise of the connection of the disease with the profession seems to be promisingly.

RADIATION DIAGNOSIS OF RARE FORMS OF RESPIRATORY ORGAN SARCOIDOSIS

Objective: to evaluate the clinical and radiological features of rare forms of sarcoidosis of the respiratory organs (SRO).Material and methods. In 2006 to 2016, the Research Institute of Interstitial and Orphan Lung Diseases followed up 599 patients with sarcoidosis. 36 patients (6.0%) of them had atypical clinical and radiation manifestations that did not correspond to the traditional radiation pattern and the existing X-ray classification of SRO. Stages 2, 3, and 4 pulmonary sarcoidosis was diagnosed in 26, 7, and 3 patients, respectively. The patients’ mean age was 38.2±7.4 years (the female/male ratio was 26:10). All the patients underwent traditional X-ray studies (radiography in two projections), high-resolution computed tomography (CT), complex external respiratory function examination, and echocardiography.Results. Analysis of the results of radiation examinations revealed the following rare forms of SRO: interstitial edematous, fibrous, and cavitary ones that had recognizable CT patterns. Each of these forms had clinical and functional features. In single cases, the CT pattern combined the features incompatible with the generally accepted classification (Stages 1 and 4 SRO); this was an offstage form. The features of the radiation pattern and clinical course required the differential diagnosis of these patients with more severe diseases (idiopathic pulmonary fibrosis, lymphogenic carcinomatosis, pulmonary edema, diffuse connective tissue diseases, pneumoconiosis, mycobacteriosis, and exogenous allergic alveolitis) and morphological verification.Conclusion. The accumulation of experience with clinical and radiological examination of patients with SRO revealed its rare forms that are difficult to diagnose and necessitate the development of new approaches to therapy policy.