Płuco rolnika

Beata Żołnowska

Streszczenie
Farmer´s lung (FL) is a granulomatous lung disease caused by a variety of environmental antigens, most notably thermophilic actinomycetes. Cellular immunity seems to play a key role in the patogenesis of FL leading to the diffuse mononuclear cell infiltration of the lung parenchyma, notably terminal bronchioles, interstitium and alveoli, witch may organize into granulomas and sometimes progress to fibrosis. Clinically FL may be acute or chronic. In acute disease affected patients presents with „flulike” symptoms 4 to 6 hours following exposure and spontaneous improvement after antigen avoidance. In such cases the differential diagnosis must include the organic dust toxic syndrome. In the chronic form, patients may show progressive dyspnea and cough on exertion with gradually deteriorating pulmonary function characterized by restrictive defects. Differential diagnosis includes granulomatous lung disorders, mainly sarcoidosis and other interstitial lung diseases. Early diagnosis and avoidance of antigen exposure are key elements of the treatment regimens. Corticosteroids are recomended in acute, severe and progressive disease.

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