1/6. 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 = 1keywords = inhalation (Clic here for more details about this article) |
2/6. 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 = 1keywords = inhalation (Clic here for more details about this article) |
3/6. Environmental challenge.A variety of organic dusts and chemicals encountered in our environment are capable of provoking a response in the lung. Frequently, they produce transient or reversible physiologic changes that may obscure the diagnosis. The patient may fail to recognize a causal relationship with a specific exposure with late-onset reactions and the development of symptoms remote from the exposure. A thorough evaluation of the individual's total environment and symptoms, with particular reference to their time course, is essential in making the diagnosis. Removal of the worker from a suspected environment, with serial clinical and physiologic monitoring to demonstrate improvement, or return to the workplace with similar studies, can be helpful in establishing a causal relationship. When a specific agent can be identified, a controlled inhalation challenge in the laboratory is the procedure of choice. Once a causal relationship has been established, the individual should be removed from exposure or the implicated agent eliminated.- - - - - - - - - - ranking = 0.5keywords = inhalation (Clic here for more details about this article) |
4/6. 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 = 0.5keywords = inhalation (Clic here for more details about this article) |
5/6. Canary fancier's lung.A 54-year-old man presented with features consistent with extrinsic allergic alveolitis occurring after contact with his pet birds. Screening of the serum for avian precipitating antibody was negative but canary precipitins were present. Extrinsic allergic alveolitis to his pet canaries was confirmed by inhalation challenge.- - - - - - - - - - ranking = 0.5keywords = inhalation (Clic here for more details about this article) |
6/6. Pigeon breeder's disease in children. A family study.The findings in a family of seven with pigeon breeder's disease are reported, and the wide range of clinical and laboratory involvement is documented. An inhalational challenge and lung biopsy were performed on the 15-year-old patient who was the index case, and the diagnostic results are discussed. We emphasize the importance of thoroughly evaluating the members of the family and the environment when a patient suspected of hypersensitivity pneumonitis is encountered. All treated members responded well to therapy with steroids and ceasing exposure to antigenic material from pigeons. serum precipitin tests to pigeon-derived antigens that were initially strongly positive in all seven family members became negative by 15 months following treatment.- - - - - - - - - - ranking = 0.5keywords = inhalation (Clic here for more details about this article) |