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Answer to your Health Question

Question (11/02/2012):

Title: What percentage of patients with allergic alveolitis also have sarcoidosis and why? .

I have been diagnosed with Sarcoidosis by my neurologist and Allergic Aveolitis better known as (farmers lung) by my pulmonologist.

My endocrinologist who handles my hypothyroidism and immune deficiency says that in a lot of cases where the patient is immune deficient that the 2 diagnosis go hand in hand.

Is this true? And what % of patients with allergic alveolitis also have sarcoidosis and why?

Answer:

Thank you very much for your question.

No one is sure what causes sarcoidosis.

Sarcoidosis is a systemic autoimmune process.

Extrinsic allergic alveolitis is caused by hypersensitivity to inhaled organic dusts.

Extrinsic allergic alveolitis and pulmonary sarcoidosis are granulomatous diseases of the lung for which clinical presentation and anatomic site of granuloma formation differ.

Extrinsic allergic alveolitis is caused by inhaled antigens, whereas the nature and sourceof the inciting antigen in sarcoidosis is unknown.

An abstract of a scientific work from König G, Baur X, and Fruhmann G. indicated that of 46 patients with sarcoidosis, there was an exposure to type III allergens in 14 subjects.

On closer examination of 2 patients diagnosed as having sarcoidosis there were distinct features suggesting farmer's lung too.

Inhalative challenge recording airway resistance, CO transfer factor and other clinical features confirmed farmer's lung disease in these patients.

Because there are sometimes poor clinical and uncertain histological differences, inhalative challenge is considered an important diagnostic procedure to differentiate hypersensitivity pneumonitis from sarcoidosis.

Sarcoidosis is generally characterized by a CD4+ lymphocyte predominance in bronchoalveolar lavage fluid (BALF), whereas in extrinsic allergic alveolitis (EAA) a CD8+ lymphocyte predominance is found.

Extrinsic allergic alveolitis and sarcoidosis are two granulomatosis of the lung characterized by non- -necrotizing granuloma. Both have typical bronchoalveolar lavage immunology, with opposite CD4/CD8 relation.

However, sarcoidosis does not have such well defined etiology as extrinsic allergic alveolitis.

It is thought that sarcoidosis of the lungs begins with alveolitis.

Sarcoidosis can cause alveolitis.



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