Hypersensitive pneumonitis

Hypersensitive pneumonitis (exogenous allergic alveolitis) – a rare inflammatory lung disease caused by inhalation exposure to various allergens found both in professional and at home.

Hypersensitive pneumonitis develops in predisposed individuals after repeated exposure to the allergen.

The reasons for the development of GP may be long-term contacts with:

• bird feathers (including feather pillows, feather and down products, poultry farming);
• agricultural and other animals (fur, skins);
• mold, including found in humidifiers and air conditioners, swimming pools and Jacuzzis, moldy hay, vegetable and granaries, compost, soil, woodworking waste, wind musical instruments, as well as used in the production of cheese, wine, beer, etc.;
• organic dust (vegetable dust: flour, soy; processing of mollusk shells, fish scales, etc.);
• compounds of inorganic nature (household chemicals, hairspray, dental materials, acrylic, resins, some metals, etc.)

In many cases, the factors contributing to the development of GP cannot be established.

Prolonged, repeated exposure to pathogens leads to the development of an inflammatory reaction in the lung tissue with the possible formation of fibrosis.

Hypersensitive pneumonitis is characterized by the following clinical symptoms:

• shortness of breath;
• unproductive cough;
• weight loss;
• Weakness;
• Subfebrile temperature;
• during auscultation of the lungs, bilateral dry "squeaking" wheezing is heard on exhalation in the lower parts of the lungs.

The diagnosis of GP is established on the basis of:

• anamnesis of the disease (long-term exposure to the allergen);
• physical examination (bilateral dry "squeaking" wheezing on exhalation in the lower parts of the lungs);
• laboratory data (determination of IgG antibodies to the suspected allergen);
• results of computed tomography of the lungs,
• assessment of the function of external respiration (spirogram, bodyplethysmography with diffusion test, 6-minute walking test, pulse oximetry);
• investigation of the cellular composition of bronchoalveolar lavage (fluid obtained by washing the bronchi during fibrobronchoscopy);
• histological examination of lung biopsy.

Multidisciplinary discussion of patients with suspected hypersensitive pneumonitis should be conducted by all in order to confirm the diagnosis and discuss treatment tactics. This is possible in the MCSC named after A.S.Loginov.