Zusammenfassung
Die exogen-allergische Alveolitis (EAA) ist eine seltene interstitielle Lungenerkrankung, die durch Inhalation von Antigenen in Stäuben, Gasen oder Aerosolen entsteht. Klinisch unterscheidet man einen akuten von einem chronischen Verlauf, der mit Ausbildung einer Lungenfibrose, aber auch selten eines Lungenemphysems einhergehen kann. Die Diagnose wird anhand einer Kombination von Diagnosekriterien, die neben einer möglichen Antigenexposition typische Symptome, spezifische IgG-Antikörper, funktionelle Einschränkungen, eine lymphozytäre Alveolitis in der BAL, charakteristische radiologische und histopathologische Befunde und ggf. eine inhalative Provokationstestung oder einen Karenztest beinhalten können, gestellt. Das klinische Bild einer chronischen EAA ist oftmals uneinheitlicher und kann daher eine größere Herausforderung darstellen. Optimalerweise erfolgt dann die Diagnosestellung analog zu anderen interstitiellen Lungenerkrankungen in einem multidisziplinären Team. Therapeutisch steht die frühe Diagnosestellung mit möglicher Antigenkarenz im Mittelpunkt. Medikamentös wird neben einer antiinflammatorischen Therapie mittels Kortikosteroiden, v. a. bei akuten Verläufen, mittlerweile auch eine antifibrotische Therapie mittels Nintedanib bei chronischen progredient-fibrosierenden Verläufen eingesetzt. Präventive Maßnahmen im beruflichen oder häuslichen Umfeld müssen berücksichtigt werden.
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Koschel, D. (2022). Exogen-allergische Alveolitis. In: Kreuter, M., Costabel, U., Herth, F.J., Kirsten, D. (eds) Seltene Lungenerkrankungen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63651-0_14
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