Alveolitis is a group of diseases in the respiratory department of the lungs with a tendency to diffuse substitution of the lung tissue connective.
Alveolitis can be idiopathic fibrosing, exogenous allergic, toxic fibrosing.
Idiopathic fibrosing alveolitis
Idiopathic fibrosing alveolitis (diffuse interstitial fibrosis, or Hamena-Rich syndrome) is a chronic lung disease with progressive diffuse pneumophilia.
It is believed that the disease develops on the background of genetic predisposition. Important role is played by collagen collagen disorders. Often found in women, the incidence of 3-7 cases per 100 thousand population.
The main symptom is shortness of breath, which appears during physical activity, but with the development of the disease is observed and at rest. Often it is accompanied by dry cough, pallor and cyanosis of the skin, increased fatigue.
Gradually, patients lose weight, performance is reduced, the shape of the nails changes - they become convex ("watch glasses"), the end phalanxes of the fingers thicken ("drum sticks"). Subsequently, pulmonary-heart failure develops. The average life expectancy of patients without treatment is no more than 4-6 years.
At inspection reveal:
- In blood - an increase in ESR, an increase in gamma globulins, the presence of specific antibodies, rheumatoid factor;
- On the x-ray of the chest - interstitial pneumosclerosis ("cellular lung");
- In the study of the function of external respiration - a decrease in lung capacity, ventilation failure;
- At bronchoscopy - narrowing and deformation of the bronchi;
- When biopsy of the pulmonary tissue - the phenomenon of vasculitis and fibrosis.
Treatment includes glucocorticoids with immunosuppressive drugs, symptomatic therapy, potassium supplements, vitamin therapy, respiratory exercises, exercise therapy.
Exogenous allergic alveolitis
This disease is caused by the inhalation of organic dust containing various allergens, associated with the immune response of the body and manifested by the development of pneumophilia. Most often it occurs in adults, but it also occurs in children (lovers of aquariums, parrots, etc.).
Types of allergens are extremely diverse: hay, grain, flour or sugar dust, bird droppings, feathers, various types of fungi (for example, aspergilli).
Inhalation of allergens leads to the formation of antibodies and immune complexes with their accumulation in the walls of the alveoli to form a granule (nodules) in the walls of the alveoli and the walls of the bronchi with subsequent replacement on the connective tissue.
The disease often occurs in the form of ARD, bronchitis, rarely - pneumonia. In constant contact with the allergen, it becomes a chronic progressive form. The disease develops in the same way as the previous form of alveolitis, and is also accompanied by the development of pulmonary heart failure.
At inspection reveal:
- In the blood - leukocytosis, the presence of specific antibodies to the antigen;
- On radiographs of the chest organs - diffuse enhancement and deformation of the pulmonary picture, diffuse fibrosis ("cellular lung");
- When studying the function of external respiration - ventilation failure with a decrease in lung capacity.
Treatment should take place against the background of termination of contact with the allergen. Medicinal treatment includes glucocorticoids (including inhalation), spasticity drugs, bronchodilators, respiratory exercises, exercise therapy.
Toxic fibrosing alveolitis
The disease develops when the toxic effects of chemicals, some drugs with the development of the immune response of the body in the form of diffuse defeat of the alveoli and pulmonary interstitial tissue.
Clinical manifestations and data of laboratory and instrumental examination methods are nonspecific, similar to other forms of alveolitis.
Treatment includes discontinuation of contact with a toxic substance or drugs, inhalation administration and ingestion of glucocorticoids, administration of drugs that improve sputum secretion, physiotherapy procedures, exercise therapy, respiratory gymnastics, speleotherapy.