Farmer's Lung
| Classification according to ICD-10 | |
|---|---|
| J67 | Allergic alveolitis from organic dust |
| J67.0 | Farmer's Lung |
| ICD-10 online (WHO version 2019) | |
As a farmer's lung ( syn. : English farmer's disease , lung farmer's ) is a alveolitis exogenous - allergic designated cause.
Symptoms
3–12 hours after mostly massive (e.g. stable work) allergen contact , fever ("threshing fever"), breathing difficulties , cough , chills and headache occur. The picture is similar to pneumonia . The symptoms subside within a few days. In the chronic form, the focus is often only on the symptoms of coughing and breathing difficulties, which last for months to years.
root cause
Sensitizing organic materials mainly come from spores of thermophilic actinomycetes (bacteria), aspergillus and other molds , as well as components of bird feathers and proteins from insects and shellfish. The discovery of further hazardous dusts must be expected. You are particularly exposed to intensive contact when keeping birds (excrement and dust) and working with moldy and then dried hay . As allergens , the inhaled mold components lead to inflammation of the alveoli and the connective tissue between them , which is triggered by an immune complex reaction (predominantly type III).
Differential diagnosis
The most important differential diagnosis is thresher fever (ODTS, organic dust toxic syndrome), which is caused by endotoxins as part of the cell wall of gram-negative bacteria. The threshing fever is not caused by allergies and can therefore occur upon first contact.
consequences
The acute form usually heals without consequences. In the chronic form , untreated and occasionally despite treatment and avoidance of allergens, scarring of the lung tissue ( pulmonary fibrosis ) can occur. This can lead to breathing difficulties (respiratory insufficiency) and to an increase in blood pressure in the small circulation with subsequent stress on the right heart ( cor pulmonale ).
therapy
The patient should avoid contact with the allergen. If this is not possible, respiratory protection must be worn. Cortisone administration should be considered in the chronic form .
Farmer's lung is a reportable occupational disease .
Web links
- J. Sennekamp et al .: Occupational exogenous allergic alveolitis ASU, Journal for Medical Prevention, 2014
- Björn Lorenzen: Studies on the role of organic dusts in the pathogenesis of exogenous allergic alveolitis Dissertation, LMU Munich, 2003
- Federal Ministry of Labor: Leaflet on BK No. 4201: Exogenous allergic alveolitis (PDF), Leaflet for medical examination, 1989
Individual evidence
- ^ Pschyrembel Online. Retrieved February 4, 2019 .
- ↑ Dr. Gerd Herold: Internal Medicine 2019 . Cologne 2018, ISBN 978-3-9814660-8-9 .
