ALLERGY RELATED PULMONARY ISSUES

 

Environmental factors including mold, dust, chemicals, and fungus can trigger allergic reactions. Symptoms may include coughing and wheezing. In some cases, individuals even experience severe coughs with blood flecks, and / or fevers.  Without treatment, lung disease can cause irreversible lung damage.

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FOUR MAIN ALLERGIC LUNG DISEASES:

  • Hypersensitivity:  This is caused by airway obstruction due to bronchospasm and hypersecretion of mucous.

  • Cytotoxic antibody-mediated disease:  This causes the air space to fill due to hypersecretion of mucous.

  • Immune complex mediated hypersensitivity:  This results in patchy consolidation and interstitial roentgenographic patterns due to antigen-antibody complexes prompting inflammation.

  • Swollen lymph nodes, nodules, and masses:  This is caused by the granulomatous reaction produced by cell-mediated immunity.

 

An example is hypersensitivity pneumonitis, which is caused by inflammation of the lungs in an allergic reaction to dust, fungus, chemicals, or mold inhaled—often at home or in the workplace. Your doctor can conduct a physical exam and hear your lungs using a stethoscope as you breathe in order to make a diagnosis.

DIAGNOSIS

The best place to start for diagnosing and treating allergy related pulmonary disease is a review of symptoms with your physician.  Some helpful diagnostic tests include:

  • Pulmonary Function Test (PFT):  This test involves measuring different aspects of the lungs and can be performed in the office to diagnose and quantify the extent of the problem.  

  • Arterial blood gas:  Blood is taken from an artery.  Measurements are performed to evaluate how well your lungs are able to get oxygen into the bloodstream and carbon dioxide (CO2) out of the bloodstream.

  • Chest X-ray:  Chest X-rays can be useful in evaluating the size of the lungs and the density of tissues within the lung.  

  • Advanced imaging (CT Scan/MRI):  Advanced imaging can be used to rule out other disease processes.

TREATMENT

Treatment begins with identifying allergens and minimizing exposure.  Treatments include:

  • Inhaled respiratory medications which include:

    • Beta agonists:  Albuterol is an example of a beta agonist.  These medications cause the smooth muscle encircling the airways​ to dilate.  This opens up the airway and allows air to pass easier, reducing the work of breathing and alleviating symptoms like wheezing.  Short acting beta agonists are RESCUE MEDICATIONS!

    • Anticholinergics:  Atrovent is an example of an anticholinergic.  These medications prevent the smooth muscle encircling the airways from returning to a relaxed state.  This helps to keep the airway open.  Anticholinergics work best in conjunction with a beta agonist.

    • Steroids:  Pulmicort is an example of an inhaled steroid.  These medications reduce the inflammation within the airways to help air move easier and reduce the work of breathing.  Steroids work best when paired with a long acting beta agonist and/or a long acting anticholinergic.

    • Mucolytics:  Mucinex is an example of a mucolytic.  These medications help to thin secretions so that they are easier to cough up.  This helps to keep the lungs clear and prevent chronic infections.

    • Flu and pneumonia shots:  Staying up to date with these shots will help to prevent more severe illness.

    • Oxygen:  If testing shows that you have a low oxygen saturation (SPO2)

  • Smoking cessation:  If you are a smoker, this is the most important step for you to take.  Your physician can help you develop a plan for quitting in addition to helping you find resources to be successful.

  • Identifying and minimizing triggers:  The smell of bleach or strong perfumes are good examples.  Identifying triggers and then either removing them or minimizing contact with them is paramount.

  • Maintaining a healthy weight:  The lungs job is to get oxygen into the body so that the cells can make energy and carbon dioxide out of the body as it is the waste produced from the creation of that energy.  The more mass you have, the more cells require oxygen and the more cells produce waste that needs to be expelled.  Therefor, the more mass you have the harder your lungs have to work to do their job.

  • Pulmonary Rehab:  If you have more severe allergy related pulmonary disease you may qualify for pulmonary rehab.  Pulmonary rehab takes place in a fitness center/gym setting and is overseen by medical professionals.  They will help you determine the proper place to start, in terms of activity and intensity level, and help you make a plan to improve your cardiopulmonary performance.  Not only does this help to optimize your lung function while attending, but gives you the tools to maintain that function after it has ended.

ALLERGY EDUCATION VIDEO