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. 1968 May;23(3):271–280. doi: 10.1136/thx.23.3.271

Allergic alveolitis in a maltworker

H F V Riddle 1,2,3, Sonia Channell 1,2,3, W Blyth 1,2,3, D M Weir 1,2,3, Melody Lloyd 1,2,3, W M G Amos 1,2,3, I W B Grant 1,2,3,1
PMCID: PMC471790  PMID: 4968543

Abstract

A further example of diffuse pulmonary hypersensitivity to an inhaled organic antigen is reported. A 42-year-old maltworker, who developed an illness resembling farmer's lung, was found to have been heavily exposed to the spores of Aspergillus clavatus. Precipitating and complement-fixing antibodies against an extract of A. clavatus were detected in his serum, a late (Arthus-type) reaction was produced by intradermal injection of the same extract, and a pyrexial reaction, accompanied by a reduction in forced vital capacity and carbon monoxide transfer factor, occurred 6 hours after the inhalation of spores of A. clavatus. Two of the patient's four workmates complained of similar but less severe symptoms, and their sera also contained specific antibodies. Although the spores of A. clavatus and of Cryptostroma corticale, the fungus responsible for maple-bark disease, are much larger than the 1 μ spores of Micropolyspora sp., they may give rise to a diffuse pulmonary hypersensitivity reaction indistinguishable from that observed in farmer's lung. This suggests that the occurrence of such a reaction is not necessarily related to the size of the inhaled particles, and there is reason to believe that the concentration of spores or other antigenic particles in the inspired air may in this respect be more important than their size. The pulmonary hypersensitivity in this group of disorders appears to be a precipitin-mediated (type III) response to a variety of inhaled antigens, but some of these antigens may in certain patients, presumably atopic individuals, also provoke a reagin-mediated (type I) bronchial hypersensitivity reaction. It is suggested that a term such as `allergic alveolitis' or `extrinsic allergic alveolitis' may suitably be used to describe the group of diseases caused by pulmonary hypersensitivity to inhaled organic antigens.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BARBEE R. A., DICKIE H. A., RANKIN J. PATHOGENICITY OF SPECIFIC GLYCOPEPTIDE ANTIGEN IN FARMER'S LUNG. Proc Soc Exp Biol Med. 1965 Feb;118:546–550. doi: 10.3181/00379727-118-29901. [DOI] [PubMed] [Google Scholar]
  2. Booker D. V., Chamberlain A. C., Rundo J., Muir D. C., Thomson M. L. Elimination of 5 mu particles from the human lung. Nature. 1967 Jul 1;215(5096):30–33. doi: 10.1038/215030a0. [DOI] [PubMed] [Google Scholar]
  3. Brown J. H., Cook K. M., Ney F. G., Hatch T. Influence of Particle Size upon the Retention of Particulate Matter in the Human Lung. Am J Public Health Nations Health. 1950 Apr;40(4):450–480. doi: 10.2105/ajph.40.4.450. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Conferences and meetings: thoracic medicine. Br Med J. 1967 Jul 1;3(5556):43–44. [PMC free article] [PubMed] [Google Scholar]
  5. DICKIE H. A., RANKIN J. Farmer's lung; an acute granulomatous interstitial pneumonitis occurring in agricultural workers. J Am Med Assoc. 1958 Jun 28;167(9):1069–1076. doi: 10.1001/jama.1958.02990260011004. [DOI] [PubMed] [Google Scholar]
  6. Emanuel D. A., Wenzel F. J., Lawton B. R. Pneumonitis due to Cryptostroma corticale (Maple-bark disease). N Engl J Med. 1966 Jun 23;274(25):1413–1418. doi: 10.1056/NEJM196606232742504. [DOI] [PubMed] [Google Scholar]
  7. FORGACS J., CARLL W. T., HERRING A. S., MAHLANDT B. G. A toxic Aspergillus clavatus isolated from feed pellets. Am J Hyg. 1954 Jul;60(1):15–26. doi: 10.1093/oxfordjournals.aje.a119700. [DOI] [PubMed] [Google Scholar]
  8. FRANK R. C. Farmer's lung; a form of pneumoconiosis due to organic dusts. Am J Roentgenol Radium Ther Nucl Med. 1958 Feb;79(2):189–215. [PubMed] [Google Scholar]
  9. GREGORY P. H., LACEY M. E. Mycological examination of dust from mouldy hay associated with farmer's lung disease. J Gen Microbiol. 1963 Jan;30:75–88. doi: 10.1099/00221287-30-1-75. [DOI] [PubMed] [Google Scholar]
  10. Hargreave F. E., Pepys J., Longbottom J. L., Wraith D. G. Bird breeder's (fancier's) lung. Lancet. 1966 Feb 26;1(7435):445–449. doi: 10.1016/s0140-6736(66)91454-1. [DOI] [PubMed] [Google Scholar]
  11. Hladká A. Príspevok k metabolizmu metationu u bielych potkanov. Prac Lek. 1966 Jan;18(1):6–10. [PubMed] [Google Scholar]
  12. LONGBOTTOM J. L., PEPYS J. PULMONARY ASPERGILLOSIS: DIAGNOSTIC AND IMMUNOLOGICAL SIGNIFICANCE OF ANTIGENS AND C-SUBSTANCE IN ASPERGILLUS FUMIGATUS. J Pathol Bacteriol. 1964 Jul;88:141–151. doi: 10.1002/path.1700880119. [DOI] [PubMed] [Google Scholar]
  13. Lunn J. A., Hughes D. T. Pulmonary hypersensitivity to the grain weevil. Br J Ind Med. 1967 Apr;24(2):158–161. doi: 10.1136/oem.24.2.158. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Mahon W. E., Scott D. J., Ansell G., Manson G. L., Fraser R. Hypersensitivity to pituitary snuff with miliary shadowing in the lungs. Thorax. 1967 Jan;22(1):13–20. doi: 10.1136/thx.22.1.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. PEPYS J., JENKINS P. A., FESTENSTEIN G. N., GREGORY P. H., LACEY M. E., SKINNER F. A. FARMER'S LUNG. THERMOPHILIC ACTINOMYCETES AS A SOURCE OF "FARMER'S LUNG HAY" ANTIGEN. Lancet. 1963 Sep 21;2(7308):607–611. doi: 10.1016/s0140-6736(63)90398-2. [DOI] [PubMed] [Google Scholar]
  16. PEPYS J., LONGBOTTOM J. L., JENKINS P. A. VEGETABLE DUST PNEUMOCONIOSES. IMMUNOLOGIC RESPONSES TO VEGETABLE DUSTS AND THEIR FLORA. Am Rev Respir Dis. 1964 Jun;89:842–858. doi: 10.1164/arrd.1964.89.6.842. [DOI] [PubMed] [Google Scholar]
  17. Pepys J., Jenkins P. A., Lachmann P. J., Mahon W. E. An iatrogenic autoantibody: immunological responses to 'pituitary snuff' in patients with diabetes insipidus. Clin Exp Immunol. 1966 Oct;1(4):377–389. [PMC free article] [PubMed] [Google Scholar]
  18. REED C. E., BARBEE R. A. PIGEON-BREEDERS' LUNG: A NEWLY OBSERVED INTERSTITIAL PULMONARY DISEASE. JAMA. 1965 Jul 26;193:261–265. doi: 10.1001/jama.1965.03090040005001. [DOI] [PubMed] [Google Scholar]
  19. SEAL R. M., THOMAS G. O., GRIFFITHS J. J. Farmer's lung. Proc R Soc Med. 1963 Apr;56:271–273. [PMC free article] [PubMed] [Google Scholar]
  20. TOTTEN R. S., REID D. H., DAVIS H. D., MORAN T. J. Farmer's lung; report of two cases in which lung biopsies were performed. Am J Med. 1958 Nov;25(5):803–809. doi: 10.1016/0002-9343(58)90019-6. [DOI] [PubMed] [Google Scholar]
  21. WENZEL F., EMANUEL D. A., LAWTON B. R., MAGNIN G. E. ISOLATION OF THE CAUSATIVE AGENT OF FARMER'S LUNG. Ann Allergy. 1964 Oct;22:533–540. [PubMed] [Google Scholar]

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