[ bagassose: extrinxic allergic alveolite]

ABSTRACT

The extrinsic allergic alveolites are interstitial and alveolar pneumopathies of complex immunological mechanisms, related to the inhalation organic chronicles of substances. We report the observation of a 61 years old, old patient nicotinic chronicle, without particular pathological antecedents, having a concept of professional exposure to the cane with sugar during 40 years. It presents 4 months before its hospitalization a dyspnea of effort of progressive aggravation currently stage IV of the EEC associated with a productive cough mucopurulente, the whole evolving/ moving in a context of apyrexie and slimming quantified to 15 kg. The clinical examination finds a patient polypneic with 26c/mn and rails crepitants bilateral with the sounding pleuropulmonaire. Thoracic radiography shows an interstitial syndrome diffuse reticulo-micronodulaire. The thoracic TDM highlights an aspect in honeycomb evoking a pulmonary fibrosis. Washing bronchioloalveolaire objectifies a rate of polynuclear neutrophiles with 6%. Respiratory functional exploration finds a moderate restrictive syndrome with a reduction in the DLCO. In front of these clinical, radiological and functional criteria, the diagnosis of the bagassose was retained. In the light of this observation, we underline the diagnostic difficulties of the alveolite allergic extrinsic and we propose a review of the literature