Bird Fancier’s Lung: Clinical-Radiological Presentation in 15 Cases

Abstract

Introduction: Bird fancier's lung (BFL) is a type of hypersensitivity pneumonitis occurring in response to avian antigens (usually inhaled proteins in bird feathers and droppings). The diagnosis is based on a combination of clinical, radiological, and biopsy characteristics. The present study was planned to highlight the clinico-radiological presentation in cases of BFL. Material and methods:The present study is a retrospective analysis of cases of bird fancier's lung diagnosed in a unit of Vallabhbhai Patel Chest Institute over a period of two years, from 2013−2014. The clinico-radiological features of the subjects were analysed. The diagnosis of BFL was made as per criteria laid down by Mark Schuyler and Yvon Cormier. Results: There were a total of fifteen cases diagnosed with BFL during the study period, comprising twelve females and three males with a mean age of 54.93 ± 14.21 years. All the studied subjects gave significant history of exposure to pigeons and were non-smokers. The period of symptoms prior to presentation varied from one to eight years. The main symptoms on presentation were exertional breathlessness and cough. Radiologically, diffuse centrilobular nodules, ground glassing -diffuse or patchy predominant in upper lobes, fibrosis with or without traction bronchiectasis, honeycombing, and mediastinal lymphadenopathy were seen. Bronchoscopy showed ill-defined granulomas and chronic interstitial inflammation. Conclusions: BFL can exhibit a wide range of radiological patterns, and a high index of suspicion must be maintained, with particular attention to detailed exposure history in every case of interstitial lung disease.

The value of serum precipitins against specific antigens in patients diagnosed with hypersensitivity pneumonitis – retrospective study

“…We confirmed the exposition to birds' antigens in 60% of HP patients, to hay or hay products in 49%, and to any of above mentioned antigens in 77% of patients. These data are in agreement with observations from other studies where birds' antigens were responsible for the most HP cases in their series [12,13].…”

Bird Fancier’s Lung—Comment on: Kumar R., Singh M. “Bird Fancier’s Lung: Clinical-Radiological Presentation in 15 Cases”

“…The authors indicated in Table 2 that a desaturation in the 6min. walk test was observed in 73% of patients [1]. However, the values of SaO 2 at rest and after effort were not shown in the paper.…”

“…The authors dedicated too little space to the evaluation of oxygen diffusion. In Table 2, only 1 patient was marked with an isolated decrease in DLco, although 13 patients had a moderate decrease in diffusion capacity [1]. The accurate elaboration of DLco was more important than presentation of FEV 1 with details.…”

“…Was enlargement of mediastinal lymph nodules observed in this patient after antituberculous treatment? Another problem is the discrepancy between frequency of occurrences of irregular lines in HRCT -in Table 2 they were visible in as many as 80% of patients and in Table 3 in only 60% [1]. In de scribed group of patients it was the most frequent finding on computed tomography.…”

Hypersensitivity pneumonitis: Diagnostic criteria, treatment, prognosis and prevention

“…U pacjentów z "płucem hodowców ptaków" choroba częściej prowadzi do nieodwracalnego włóknienia płuc i około 30% chorych umiera w ciągu kilku lat od ustalenia rozpoznania [15,17,43].…”