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Exogenous allergic alveolitis - Symptoms
Last reviewed: 04.07.2025
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Acute exogenous allergic alveolitis develops 4-12 hours after the antigen enters the patient's respiratory tract, either orally or parenterally. Patients quickly develop the following characteristic complaints: fever, chills (mainly in the evening), dry cough or cough with a small amount of mucous sputum, severe weakness, chest pain (may increase with deep inhalation), muscles, joints, headache, shortness of breath at rest and especially with physical exertion. Attacks of difficulty breathing are also possible. The above subjective manifestations of the disease are often assessed by the doctor as influenza, acute bronchitis or pneumonia.
An objective examination of patients reveals cyanosis, shortness of breath (sometimes with difficulty exhaling); auscultation of the lungs reveals crepitations, small and medium bubbling rales, and sometimes scattered dry rales.
Acute exogenous allergic alveolitis may acquire a severe progressive course (with continued contact with the etiologic factor) with increasing respiratory failure. When the influence of the exogenous allergen ceases, the symptoms of exogenous allergic alveolitis are quickly relieved.
The subacute form of exogenous allergic alveolitis usually develops when the body is exposed to relatively small doses of the antigen. The disease develops gradually and is characterized by shortness of breath (mainly with moderate physical exertion), significant weakness, sweating, subfebrile body temperature, cough with the separation of a small amount of mucous sputum, and loss of appetite. Crepitation and fine bubbling rales are detected during auscultation of the lungs. In the subacute form, an intermittent course is often observed - after contact with the allergen ceases, the clinical manifestations of the disease decrease (for example, on days of rest, vacation). After resumption of work and contact with the allergen, the disease worsens again, and the exacerbation can be quite pronounced.
The chronic form of exogenous allergic alveolitis develops with long-term contact with small doses of an exogenous allergen. This form of the disease is characterized by progressive respiratory failure (pronounced dyspnea, cyanosis with a grayish-ash tint), significant weight loss, sweating, loss of appetite, cough with the separation of mucous sputum. Physical examination of the lungs reveals: widespread diffuse crepitation, fine bubbling rales, a "squeaking" symptom (in the presence of pleuro- and pneumofibrosis). Chronic pulmonary heart disease develops, and its decompensation is possible. Many patients develop thickening of the terminal phalanges of the fingers in the form of "drumsticks" and nails in the form of "watch glasses".
Thus, the chronic form of exogenous allergic alveolitis is very similar to idiopathic fibrosing alveolitis.
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