Contents
What is alveolitis?
Alveolitis is a disease that involves damage to the alveoli or pulmonary vesicles. The inflammatory process often leads to fibrosis of lung tissue. Alveolitis develops independently under the influence of a number of external stimuli or is a consequence of another disease.
The following types of diseases are distinguished:
Idiopathic fibrosing alveolitis
It is called diffuse or interstitial pneumofibrosis, Hamman-Rich syndrome. This type of alveolitis is less common than others, and men suffer from it much more often than women. Hamman-Rich syndrome manifests itself in the form of lesions of the pulmonary interstitium, which subsequently leads to the development of respiratory failure and pneumosclerosis.
The main symptoms of idiopathic alveolitis are severe cough and shortness of breath. The disease is rarely detected in the early stages, so in most cases an accurate diagnosis is made with an anamnesis of at least 3 months, and often several years. The first symptoms of idiopathic alveolitis do not cause concern in patients. The body gradually adapts to shortness of breath and coughing. To avoid the manifestation of these symptoms, patients, as a rule, begin to lead a less mobile lifestyle. When conducting an x-ray examination, the picture shows a deformation of the pulmonary pattern, an increased volume of connective tissue, which grows as the disease progresses.
The development of pulmonary fibrosis gradually reduces the chances of recovery. Timely treatment allows you to almost completely get rid of idiopathic alveolitis. However, patients have to be under the supervision of a doctor all their lives and undergo periodic examinations. In the absence of treatment, in most cases, after a few months or years, a fatal outcome occurs.
More: Idiopathic fibrosing alveolitis
Exogenous allergic alveolitis
The cause of the development of the disease is external irritants: plant dust, fungal spores, drugs. There are two ways of getting them into the body: inhalation and non-inhalation, which is very rare. A large number of subtypes of exogenous allergic alveolitis have been identified, depending on the specific type of irritant. Bird lovers and furriers suffer from this disease, which is due to the constant work with fur and feathers, farmers who deal with rotten hay.
Depending on the frequency of contact with the irritant that caused the alveolitis, an acute, subacute and chronic form is possible. The patient’s lungs have blackouts, their transparency decreases. In the chronic form, the density of the tissues of the respiratory tract gradually increases. The basis of effective treatment of allergic alveolitis is the elimination of contact with the irritant. Without this, the use of drugs will be ineffective.
More: Exogenous allergic alveolitis
Toxic alveolitis
Appears under the influence of the direct action of toxic substances on the lungs. Drugs that cause the development of the disease are drugs, for example, sulfonamides, immunosuppressants, or chemical toxicants, such as zinc, talc, ammonia, chlorine. They can enter the body with the blood stream or directly in the process of breathing.
If you do not stop exposure to irritants, the disease will become chronic. It is dangerous due to the formation of fibrous tissue that replaces the damaged epithelial. Over time, this will lead to the loss of the alveoli of their main functions.
Symptoms of lung alveolitis
The following symptoms of alveolitis can be distinguished:
Dyspnea. At first, patients may not attach much importance to it and not seek help from specialists, since breathing difficulties occur only during active movements. But gradually shortness of breath increases, occurs even when walking at a moderate pace. Most often, patients with alveolitis turn to the doctor 3 months after its appearance or even after several years.
Cough. Most often occurs in idiopathic alveolitis. Cough may be accompanied by wheezing, especially in patients suffering from bronchitis, but the blood is not expectorated.
Pain. They are felt in the chest and under the shoulder blades. Discomfort in this area can prevent you from taking deep breaths.
Deterioration of the general condition of the patient. Many patients lose weight, they have constantly elevated body temperature and weakness. Patients suffering from alveolitis may experience pain in the joints and muscles. Fibrosing alveolitis leads to deformity of the fingers.
respiratory failure;
enlargement of neck veins and edema;
cachexia;
This condition is characterized by an extreme form of exhaustion of the body, in which the patient complains of general weakness in the body, loses weight. All this is accompanied by a slowdown in physiological processes and negatively affects the psyche. Loss of appetite leads to a lack of vitamins, as a result of which the skin acquires an earthy, pale tint. The patient becomes lethargic, his performance decreases, and the subcutaneous tissue decreases sharply.
Causes of lung alveolitis
There are the following causes of alveolitis:
Viruses. Among them are the hepatitis C virus, herpesvirus, cytomegalovirus, HIV. By acting on the immune system, they weaken it, as a result of which the body is more susceptible to external stimuli.
Наследственность. The exact influence of this cause has not been established, but there is an assumption that genes also affect the development of alveolitis.
autoimmune factor;
external stimuli.
They can be chemical preparations or natural substances, for example, bird feathers and droppings, fur, bark, raincoat fungus spores, sawdust, rotten hay, rotten coffee, and even some types of cheese. However, they can cause alveolitis with constant contact. Typically, such external stimuli of natural origin lead to the development of an allergic type of disease, and chemicals to a toxic one.
What diseases can be associated with?
Fibrosing alveolitis can be combined with various diseases. First of all, it is a vasculitis that affects the lung walls. It is diagnosed during X-ray. Alveolitis can also be accompanied by candidiasis. This secondary disease manifests itself in the form of dark spots on the lungs and leads to their fibrosis.
Often, along with alveolitis, lupus erythematosus, hepatitis C, HIV are diagnosed. The association of the disease even with rheumatoid arthritis has been established. Viral infections, such as HIV and hepatitis C, in some cases cause alveolitis. The disease has similar symptoms with sarcode and pneumonia. This requires additional studies to make an accurate diagnosis.
Complications
Alveolitis, if left untreated, leads to the development of serious complications, including progressive respiratory failure, cor pulmonale, and even pulmonary edema. It is caused by the ingress of the liquid part of the blood into the lung tissue, as a result of which gas exchange is disturbed. In this case, the patient needs to provide urgent medical care in time, otherwise a fatal outcome occurs.
Depending on the course, pulmonary edema can be of several types:
Fulminant – characterized by rapid development and a sharp deterioration in the patient’s condition, resulting in death;
Acute – develops within a few hours and often also causes death;
Subacute – in this case, the manifestation of symptoms alternately intensifies and weakens;
Protracted – this type of pulmonary edema is more characteristic of alveolitis, develops within 12-24 hours.
Treatment of lung alveolitis
Treatment of alveolitis should be carried out under the constant supervision of a physician. Specific methods vary depending on the type of disease. With toxic and allergic alveolitis, along with the use of drugs, it is necessary to eliminate the external irritant that caused its development.
In fibrosing alveolitis, glucocorticoids are used. In this case, it is important to start treatment on time, since the rapid replacement of epithelial tissue with fibrous tissue causes the alveoli to cease participation in the respiratory process, which can lead to a detailed outcome. If glucocorticoids are ineffective, penicillamine and immunosuppressants come to the rescue (more on the treatment of exogenous allergic alveolitis).
Allergic and toxic alveolitis requires the use of glucocorticosteroids. But first of all, the external irritant that caused the disease is eliminated. Allergic alveolitis is also dangerous for the development of fibrosis. To speed up the recovery of patients with this disease allows an additional course of vitamins, breathing exercises and special physical exercises. (more about the treatment of idiopathic fibrosing alveolitis)
Treatment during pregnancy
Pregnant women should pay special attention to their health in order to prevent the development of alveolitis. This disease is dangerous for the health of mother and child. In addition, it is extremely difficult to carry out its treatment. Many drugs that are used to combat various types of alveolitis are contraindicated in pregnant women, some of them cause vomiting, dizziness and other side effects.
If the disease could not be avoided, you should contact a highly qualified specialist. He will be able to prescribe treatment that is safe and effective for pregnant women, as well as assess the risk of damage to the fetus and the threat to the health of the mother.
Prevention of alveolitis
Prevention of alveolitis involves observing the rules for working with toxic substances, eliminating irritants that cause an allergic reaction. It is necessary to regularly undergo examination by a pulmonologist and a rheumatologist. Prevention of alveolitis with the help of drugs is not provided.