Alveolar inflammation

Introduction The common causes of alveolitis are organic dust containing actinomycetes and fungal spores, animal and plant proteins, bacteria and their products, insect antigens and certain chemicals. The antigenic nature of some dust is still unclear. It is generally believed that the cause of peasant lungs is mainly common high temperature actinomycetes. In recent years, domestic scholars have reported another strain of high temperature actinomycetes associated with peasant lungs, a thermostable Streptomyces, in many antigens, the most common and important thermophilic actinomycetes, especially microspores are second High temperature actinomycetes. The fungus has the form of fungi, but it belongs to the bacteria in the moist, warm, mildewed organic matter, composting, soil, food and polluted water, which contains a large amount of the bacteria inhaled by moldy hay, grain and sugarcane.

Cause

Common organic dusts including actinomycetes and fungal spores, animal and plant proteins, bacteria and their products, insect antigens and certain chemicals. The antigenic nature of some dust is still unclear. It is generally believed that the cause of peasant lungs is mainly common high temperature actinomycetes. In recent years, domestic scholars have reported another strain of high temperature actinomycetes associated with peasant lungs, a heat-absorbing Streptomyces. Among many antigens, thermophilic actinomycetes are the most common and important, especially microspores, followed by common high-temperature actinomycetes. The bacterium has a fungal form but belongs to bacteria.

It is found in moist, warm, and mild organic matter. Compost, soil, food, and contaminated water contain a large amount of this bacteria. Farmers are often susceptible to inhalation of moldy hay, grains and sugar cane. There are many thermophilic actinomycetes in the air for planting mushrooms and the environment of the production environment, and the main high-temperature actinomycetes are mainly used, and the inhalation of the growers can cause the mushroom to work. The lungs of poultry breeders (such as pigeons, lungs, parrots, etc.) are caused by bird serum, bird droppings, bird feather cream and bird eggs.

Some people think that the powder cream on the pigeon feather is a keratin particle antigen about 1m in size, and its pathogenic effect is more important than the pigeon serum and excrement. In addition, domestically reported sputum textile workers inhaled mulberry silk dust (probably sericin) in the air of the workshop to cause allergic alveolitis. The cause of the humidifier and air conditioner lung is white thermophilic actinomycetes. After inhalation of toluene diisocyanide and phthalic anhydride in the chemical industry, the hapten may also cause allergic alveolitis. Regarding tobacco growers, tea growers, etc., the antigenic properties are not fully understood.

an examination

Related inspection

Bronchoalveolar lavage (BAL) lung biopsy

(1) The x-ray varies according to the stage of disease and the degree of disease. Early or mild patients may have no abnormal findings, and sometimes clinical manifestations and x-ray changes are not consistent. In the acute phase of typical cases, diffuse lung texture is thickened in the middle and lower lungs, or small, blurred edges are scattered in the nodules. The lesion can be reversed and absorbed by the shadows several weeks after contact. In the late chronic phase, the lungs are widely distributed with reticulated nodular shadows with reduced lung volume. There are often multiple small cystic transparent areas, which are honeycomb lungs.

(2) The typical change of lung function is restrictive ventilatory disorder, the forced vital capacity and total lung volume are reduced, and the 1 second rate is increased. Both carbon monoxide diffusion and lung compliance were reduced. Arterial oxygen saturation is reduced in severe and advanced patients. Pulmonary dysfunction in patients with chronic disease is mostly irreversible.

(3) Serological examination The positive reaction of precipitated antibodies suggests that the human body has been exposed to the corresponding antigen. If there is a corresponding history of contact, symptoms and signs, x-ray performance, positive reactions are extremely helpful for diagnosis.

(4) Bronchoalveolar lavage in the bronchoalveolar lavage fluid of exogenous allergic alveolitis, the proportion of lymphocytes increased, and the ratio of igg and igm also increased. In recent years, many authors believe that bronchoalveolar lavage fluid is of great value in the diagnosis of exogenous allergic alveolitis. It can be exempted from lung biopsy, which is helpful for early treatment and prevention of disease progression.

(5) Inflammatory tests such as clinical suspected diagnosis of this disease, and patients with negative serological tests can be used as an excitation test. Some authors used the moldy hay extract in the lungs of the farmers for inhalation. Most patients responded, such as fever, leukocytosis, and increased ventilation per minute. The control group did not respond. Because the exogenous allergic alveolitis challenge test is not standardized, it is not suitable for the antigen that has been confirmed to cause pulmonary symptoms, especially those with severe lung damage.

Differential diagnosis

Viral pneumonia, miliary tuberculosis, sarcoidosis, idiopathic pulmonary fibrosis, and bronchial asthma must be distinguished from exogenous allergic alveolitis. Exogenous allergic alveolitis is differentiated from bronchial asthma.

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