Exogenous allergic alveolitis: symptoms

The acute form of exogenous allergic alveolitis develops 4-12 hours after the antigen enters the patient's respiratory tract, inside or parenterally. The following typical complaints quickly appear in patients: fever, chills (mainly in the evening), coughing dry or with the separation of a small amount of mucous sputum, severe weakness, chest pain (may intensify with deep inspiration), muscles, joints, headache , dyspnea at rest and especially with physical exertion. There are also bouts of shortness of breath. These subjective manifestations of the disease are often regarded by a doctor as influenza, acute bronchitis or pneumonia.

In an objective study of patients, cyanosis, dyspnea (sometimes with difficulty exhalation) is detected, with auscultation of the lungs it is determined crepitation, small- and medium-bubbling rales, sometimes scattered dry rales.

The acute form of exogenous allergic alveolitis can acquire a severe progressive course (with continued contact with the etiological factor) with increasing respiratory insufficiency. When the effect of the exogenous allergen ceases, the symptoms of exogenous allergic alveolitis are quickly stopped.

The subacute form of exogenous allergic alveolitis develops usually when the body is exposed to relatively small doses of antigen. The disease develops gradually and is characterized by shortness of breath (mainly with moderate physical exertion), marked weakness, sweating, subfebrile body temperature, cough with separation of a small amount of mucous sputum, a decrease in appetite. With auscultation of the lungs, crepitation, finely bubbling rales are determined. In subacute form, intermittent flow is often observed - after the termination of contact with the allergen, the clinical manifestations of the disease decrease (for example, on days of rest, leave). After resuming work and contact with the allergen, the disease becomes aggravated again, and the aggravation can be quite pronounced.

Chronic form of exogenous allergic alveolitis develops over many years of prolonged contact with small doses of exogenous allergen. This form of the disease is characterized by progressive respiratory failure (pronounced dyspnea, cyanosis with a grayish-ashy tinge), significant weight loss, sweating, lack of appetite, cough with separation of mucous sputum. In the physical examination of the lungs, the following are determined: crepitations of a widespread diffuse character, small bubbling rales, a symptom of "pokepanie" (with pleurophrosis and pneumofibrosis). A chronic pulmonary heart is formed, and its decompensation is possible. Many patients have a thickening of the terminal phalanges of the fingers in the form of "drumsticks" and nails in the form of "watch glass".

Thus, the chronic form of exogenous allergic alveolitis is very similar to idiopathic fibrosing alveolitis.

[1], [2], [3], [4]