1/15. A family with extrinsic allergic alveolitis caused by wild city pigeons: A case report.We describe a family in which the mother died of unresolved lung disease and whose 5 children, some of whom had previous signs of asthma, were subsequently affected by extrinsic allergic alveolitis caused by contact with wild city pigeon antigens. The children received systemic corticosteroids for 1 month and inhaled steroids for 24 months, while antigen exposure was reduced as much as feasible. This was followed by a quick clinical recovery and a slow normalization of chest radiographs and pulmonary function indices, especially of diffusion capacity, during a follow-up of 24 months. Because pigeon-breeder's lung caused by free-roaming city pigeons has not been previously described, it remains unclear whether this family developed the disease because of high antigen exposure or because of increased susceptibility. None of the supposedly high-risk human leukocyte antigen types were found in the children. Whether human leukocyte antigen B7 in 1 child played a role in the course of the illness remains speculative. It is unknown to what extent pigeon-breeder's lung caused by nondomestic birds remains undetected and misdiagnosed as difficult or steroid-resistant asthma. The question remains whether free-roaming city pigeons are indeed a public health risk. We suggest that atypical outdoor antigens be considered in all patients with nonresolving chest disease or therapy-resistant asthma.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/15. Subacute hypersensitivity pneumonitis in an hiv infected patient receiving antiretroviral therapy.Abnormal pulmonary immune response to various antigens can lead to hypersensitivity pneumonitis. This disease has not previously been reported in hiv infected patients. This case report describes an hiv infected woman who developed subacute hypersensitivity pneumonitis in response to bird exposure. The disease manifested itself only after the patient experienced an improvement in her CD4 positive T lymphocyte count secondary to antiretroviral therapy. This case emphasises the need to consider non-hiv associated diseases in patients with hiv and suggests that diseases in which host immune response plays an essential role in pathogenesis may become more prevalent in hiv infected patients receiving effective antiretroviral therapy.- - - - - - - - - - ranking = 0.16666666666667keywords = antigen (Clic here for more details about this article) |
3/15. Feather duvet lung.BACKGROUND: bird fancier's lung (BFL) is a type of hypersensitivity pneumonitis, which is induced by inhalation of bird related antigens. The diagnosis of BFL induced by feathers is difficult because feathers are generally not recognized as a causative antigen of BFL. We report a female case of chronic BFL presumably due to a feather duvet, which presents as pulmonary fibrosis. CASE REPORT: A 73 year-old woman presented with exertional dyspnea for the last three years. She had raised two pigeons for three years (1971-1973) in her forties and had been using a feather duvet for the last eight years (1992-2000). A chest X-ray showed reticular infiltrates in the both peripheral lung field and an HRCT scan showed scattered consolidation, micronodules, and peribronchial ground-glass opacities. Lymphocyte proliferation to the feather antigen was positive and inhalation provocation test using a bird antigen was also positive. Thoracoscopic biopsy specimens showed organization, cholesterol clefts, alveolitis around terminal and respiratory bronchioles--all of which are consistent with chronic hypersensitivity pneumonitis. Clinical findings have spontaneously improved after she stopped using her feather duvet. CONCLUSIONS: Feather beds including duvets, pillows, and cushions are now popular all over the world. physicians should be aware of feathers as a cause of BFL since this induction seems to be more prevalent.- - - - - - - - - - ranking = 0.66666666666667keywords = antigen (Clic here for more details about this article) |
4/15. hypersensitivity pneumonitis in children: pigeon breeder's disease.hypersensitivity pneumonitis (HP), an extrinsic allergic alveolitis, is a group of immunologically mediated, diffuse inflammatory lung parenchymal diseases. Pigeon breeder's disease (PBD) is one of the most common clinical forms of HP. It is caused by inhalation of various pigeon-derived materials and can present in different clinical forms. The diagnosis is difficult and the best diagnostic tool is correlation of onset of symptoms with time of exposure. Precipitating antibodies against the avian proteins form the characteristic precipitin reactions. The most effective treatment is avoidance of the antigens. steroids, either systemic or topical (inhalational), can be used to treat HP. We report five children with different clinical forms of PBD in whom the diagnosis was confirmed by positive serum precipitating antibodies to avian proteins. Although the disease is rarely seen in children, it should be considered in any child with recurrent or unexplained respiratory symptoms. Nebulising steroids might be a useful alternative treatment for allergic alveolitis.- - - - - - - - - - ranking = 0.16666666666667keywords = antigen (Clic here for more details about this article) |
5/15. Extrinsic allergic alveolitis: problems in diagnosis and a potential use for computed tomography.bird fancier's lung, the most common form of extrinsic allergic alveolitis in Britain, can be a difficult diagnostic problem. The symptoms are non-specific, often insidious in onset and frequently misdiagnosed as influenza or a viral or bacterial pneumonia. Frequently there is a delay in eliciting the history of exposure to the antigen. The chest radiograph is often less impressive than the clinical presentation and may be normal despite severe symptoms, impaired respiratory function and florid pathological changes. We present three cases demonstrating these diagnostic problem. In two cases, high resolution computed tomography demonstrated the typical 'ground glass' opacification seen in active alveolitis. This allowed targeting of transbronchial biopsies which revealed an inflammatory infiltrate of the interstitium with granuloma formation and inflammatory cells in some alveoli. The problems in diagnosis and the potential role of high resolution computed tomography are discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = antigen (Clic here for more details about this article) |
6/15. Local pulmonary immunity in pigeon breeder's disease. A case study.We studied pulmonary and systemic aspects of the immune response in a patient with pigeon breeder's disease before and after an inhalation challenge with pigeon serum. Macrophage migration inhibition was induced with bronchoalveolar wash cells exposed to both pigeon serum and pigeon dropping extract before but not after challenge. Peripheral blood lymphocytes exposed to these antigens did not induce inhibition of guinea pig peritoneal macrophage migration before challenge. However, after challenge peripheral blood lymphocytes did cause macrophage migration inhibition when exposed to pigeon serum. Both systemic and bronchoalveolar lymphocytes proliferated when exposed to these pigeon antigens in vitro. Our patient represents the first reported case of lymphokine production by pulmonary as well as systemic lymphocytes in hypersensitivity pneumonitis.- - - - - - - - - - ranking = 0.33333333333333keywords = antigen (Clic here for more details about this article) |
7/15. 'Atypical pneumonia' due to parakeet sensitivity: bird fancier's lung in a 10-year-old girl.p6trinsic allergic alveolitis is rare in childhood, with most of the cases reported due to exposure to avian precipitins (Stiem et al. 1966; Dinda et al. 1969; Chandra & Everly Jones 1972; El-Hefny et al. 1980). We report a 10-year-old girl with bird fancier's lung, and suggest that environmental antigens should be sought in children presenting with non-resolving chest disease.- - - - - - - - - - ranking = 0.16666666666667keywords = antigen (Clic here for more details about this article) |
8/15. antibodies to pigeon antigens in pigeon breeders. Detection of antibodies by an enzyme-linked immunosorbent assay.antibodies to whole pigeon serum (PS) and pigeon dropping extract (PDE) were investigated in pigeon breeders and controls by an enzyme-linked immunosorbent assay (ELISA). The optimal antigen concentration was in the range of 3-30 microgram protein/ml for both PS and PDE. PDE antibody titres greater than or equal to 10240 were found in three (75%) of four patients with pigeon breeders' disease (PBD) and in 19 (13.6%) of 140 other pigeon breeders (P = 0.011). PS antibody titres greater than or equal to 10240 occurred in all four (100%) PBD patients and in only seven (5.0%) of 140 other breeders (P = 0.0002). In 85 blood donors antibodies in low titres against PS and PDE occurred in 4.7% and 7.1%, respectively. By immunodiffusion three or more precipitin lines were found more often in PBD patients than in other breeders (P = 0.0006), and the highest ELISA antibody titres occurred in patients with precipitating antibodies. No correlation between P blood group phenotypes or anti-P1 antibodies and respiratory symptoms or antibodies to pigeon antigens could be demonstrated.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
9/15. Chronic airflow obstruction in a patient with pigeon breeder's lung: prevalence of IgE antibodies to avian antigens.We report a case of pigeon breeder's lung in which chronic airflow obstruction and not restrictive lung disease was predominant. The patient's disease was severe enough to require hospitalizations twice to reverse respiratory failure. helium-oxygen flow volume curves were consistent with a peripheral site of flow limitation, and immunoserological studies disclosed specific IgE as well as precipitating antibody responses to pigeon antigens. Immunological studies on 18 other patients with pigeon breeder's lung demonstrated a prevalence rate of specific IgE antibodies of 78%, a frequency not previously recognized. Exposures to avian antigens must be considered in patients with obstructive lung disease of unknown etiology.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/15. Subacute cor pulmonale in hypersensitivity pneumonitis. A case report.A 37-year-old non-smoking woman exposed to avian antigens developed progressive respiratory symptoms over several months, culminating in cor pulmonale. Transient nodular shadowing was noted on the chest radiograph, and pulmonary function tests showed a predominantly obstructive pattern. Elimination of antigenic exposure and treatment with diuretics and subsequently corticosteroids resulted in marked but incomplete improvement.- - - - - - - - - - ranking = 0.33333333333333keywords = antigen (Clic here for more details about this article) |
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