Alveolitis, allergic

In type III or immunocomplex-mediated allergy, IgG antibodies form complexes with antigen. At low exposures, the body is able to remove diese complexes, but if there is a severe exposure, immunocomplexes release a variety of proinflammatory cytokines. The involvement of this mechanism is clearest in serum sickness. This mechanism is also considered to be most important in the development of extrinsic allergic alveolitis (hypersensitivity pneumonitis, especially... 

Allergic alveolitis An allergic response to inhalation of organic particles that involves inflammation of the small terminal branches of the bronchioles. Symptoms include coughing, increased production of mucus, fever, fatigue, and muscle aches. 

RESPIRATORY SENSITIZER A substance that may cause sensitization on inhalation, causing, e.g., asthma, rhinitis or extrinsic allergic alveolitis. 

Baur, X. (1995) Hypersensitivity pneumonitis (extrinsic allergic alveolitis) induced by isocyanates. J. Allergy din. Immunol.. 95, 1004-1010... 

A 64-year-old woman with allergic alveolitis caused by parakeet feathers improved with intravenous methylprednisolone, and was given oral deflazacort 60 mg/day, to be reduced progressively. After 30 days she developed generalized itchy blotches and lip edema. At that time she was mistakenly taking deflazacort in a dose of 120 mg/day. She was given an antihistamine, without any improvement. Deflazacort was then replaced by prednisolone and her symptoms disappeared immediately. Skin tests (a prick test and an epicutaneous test) were positive with deflazacort. Oral provocation with deflazacort 30 mg was positive, with the immediate appearance of the same symptoms as in the initial episode. 

All isocyanates are known to cause pulmonary toxicity. Isocyanates are the most common causes of occupational asthma and have led to the development of immediate or late asthma among workers. Isocyanates have caused bronchitis, rhinitis, conjunctivitis, chronic obstructive lung disease, contact sensitivity, dermatitis, allergic alveolitis, and immunologic hemorrhagic pneumonitis.29... 

Respiratory toxicity Upper respiratory system (nose, pharynx, larynx, and trachea) and the lower respiratory system (bronchi, bronchioles, and lung alveoli) Pulmonary irritation Asthma/bronchitis Emphysema Allergic alveolitis Fibrotic lung disease Lung cancer... 

Besides respiratory allergies with hay-fever-like symptoms and asthma in atopic individuals, continuous occupational basidiospore exposure may result in hypersensitivity pneumonitis or extrinsic allergic alveolitis. The basidiomycetes Lentinus edodes, Pleurotus ostreatus, and Merulius lacrymans have all been shown to cause hypersensitivity pneumonitis from occupational exposure [26-28]. Actinomycetes in the compost used to grow button mushroom... 

O Brien IM, Bull J, Creamer B, Sepulveda R, Harries M, Bulge PS, Pepys J Asthma and extrinsic allergic alveolitis due to Merulius lacrymans. Clin Allergy 1978 8 535-542. 

Huuskonen MS, Husman K, Jarvisalo J, Korhonen O, Kotimaa M, KuuselaT, et al Extrinsic allergic alveolitis in the tobacco industry. Br J Ind Med 1984 41 77-83. 

Left ventricular failure can result in pleural effusions. Asthma can be provoked. Cross-reactivity with aspirin has been noted (8). A picture resembling allergic alveolitis has been described (9). 

On admission the first clinical presentation consists mainly of edema, which is of sudden onset and localized to the cervico-fadal region [33]. Dyspnoea, tachypnoea and asphyxia with chest pain following acute PPD poisoning have been reported in a number of studies [6] [12] [28]. PPD was proved to be the cause of asthmatic attacks in the sensitive individuals [46]. A case of Goodpasture s syndrome was reported to be induced by exposure to PPD [47]. Extrinsic allergic alveolitis also has been reported [48]. 

Wang GH, Jiang XF, Luo WC. Report of two cases of extrinsic allergic alveolitis and review of the relevant literature. Chung Hua Chich Chih 1994 1 376-8, 384. 

Dietemann-Molard A, Braun JJ, Sohier B, Pauli G. Extrinsic allergic alveolitis secondary to carmine [letter]. Lancet 1991 338 460. 

Selective inhibition of inflammatory cytokines is also an attractive approach. In animal models, antibodies to TNFa prevent lung fibrosis when given prior to injury from silica, bleomycin or antigen-induced extrinsic allergic alveolitis (Piguet etal., 1989, 1990 Denis et al., 1991). This approach may be an option in humans since TNFa antibodies have been used successfully as a therapy in patients with rheumatoid arthritis (Elliot etal., 1993). 

Extrinsic allergic alveolitis also has been reported... 

Includes chemical bums, metal fume fever, occupational asthma, occupational intrinsic allergic alveolitis, byssinosis, underground coal-miner bursitis and dental erosion by acids. 

Extrinsic allergic alveolitis Farmer s lung Mouldy hay Micropolyspora faeni... 

CBA does not appear to involve the alveolar areas of the lung. When such involvement is noted, the clinical manifestations are somewhat different, and they are classified as various types of allergic alveolitis. It is possible that many of these allergic bronchopulmonary diseases have similar pathophysiologic mechanisms. 

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