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Occupational extrinsic allergic alveolitis

¹ Regional Unit for Occupational Lung Disease, Department of Respiratory Medicine, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, ² School of Cell and Molecular Biosciences, Newcastle University, ³ School of Applied Sciences, Northumbria University and ⁴ Radiology Department, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK

Correspondence: S J Bourke

• Extrinsic allergic alveolitis (EAA) is an immune disease in which certain antigens provoke granulomatous inflammation in the distal airways and alveoli of susceptible subjects.
  
• Bird breeder's lung, farmer's lung and humidifier lung are the commonest clinical EAA syndromes in the UK.
  
• Acute EAA presents as breathlessness, fever and malaise occurring 4 h to 8 h after antigen exposure. Chronic EAA is characterized by chronic breathlessness and lung fibrosis.
  
• EAA is a dynamic and variable condition which remits and recurs in relation to antigen exposure. Chest radiographs may be normal between episodes, but typically show subtle diffuse lung infiltrates during acute disease.
  
• High resolution CT in EAA typically shows areas of ground-glass opacification and areas of reduced attenuation in sub-acute disease. Interstitial fibrosis and emphysema are features of chronic EAA.
  

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