A follow-up study of pulmonary function tests, bronchoalveolar lavage cells, and humoral and cellular immunity in bird fancier's lung☆,☆☆
Section snippets
Subjects
Five patients with BFL (three pigeon breeders and two budgerigar fanciers) were studied repeatedly for various parameters during the 5 years of follow-up. Patients with pulmonary fibrosis and history of avian contact but no episodes of acute symptoms were excluded from the study. The diagnosis of BFL was based on the clinical history, chest roentgenogram, computed chest tomography, antibodies in the sera and BAL fluids to pigeon dropping extract (PDE) or budgerigar dropping extract (BDE),
Sequential follow-up of pulmonary function tests
All five patients with BFL underwent repeat pulmonary function tests on several occasions, and the results were expressed as percent VC, percent FEV1, and percent DLCO including the values of PaO2. The results of the pulmonary function tests are shown in Fig. 1. One patient showed a deterioration in percent VC and percent DLCO, whereas PaO2 remained in the normal range of 81.4 to 95 mm Hg. All of the remaining four patients showed improvement in percent VC, although three of the four patients
DISCUSSION
BFL is an immunologic lung disease associated with exposure to bird-related antigens.1, 2 The long-term outcome of BFL is variable, because some patients may have pulmonary fibrosis and others may improve despite the reduced but continued antigen exposure. The study of the longitudinal course of 18 cases of acute pigeon breeder's lung revealed that most subjects showed improvement in pulmonary function test results and chest roentgenograms in spite of the continued exposure to pigeons.14
In this
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Cited by (61)
Hypersensitivity pneumonitis
2019, Difficult to Diagnose Rare Diffuse Lung DiseaseAn immunoproteomic approach revealed antigenic proteins enhancing serodiagnosis performance of bird fancier's lung
2017, Journal of Immunological MethodsCitation Excerpt :Following inhalation of antigens, immune complexes are formed in the alveolar and bronchiolar walls leading to tissue damage, fibrosis or emphysema. Evidence is supported by the presence of high titers of specific IgG antibodies to the offending antigens in both the circulation and bronchoalveolar lavage fluids (BAL) (Yoshizawa et al., 1995). The immunologic mechanisms involved in the disease have been described as a combination of type III (immune-complex-mediated reaction) and IV reaction (granuloma formation) with activation of alveolar macrophages and T lymphocytes (Costabel et al., 2012).
Diagnostic implications of positive avian serology in suspected hypersensitivity pneumonitis
2017, Respiratory MedicineCitation Excerpt :Titers decreased with time as steroid treatment was provided and exposures eliminated [9]. Yoshiwaza and colleagues noted drop in serum IgG levels and resolution of BAL lymphocyte proliferation after 3 years of antigen avoidance [10]. These findings support ongoing and active exposure as correlating with higher antibody titers, perhaps making disease presence more probable.
Utility of immunological tests for bird-related hypersensitivity pneumonitis
2015, Respiratory InvestigationCitation Excerpt :Clinical data, smoking history, serum C-reactive protein (CRP) concentration, and data related to LDH, Krebs von den Lungen 6 (KL-6), surfactant protein D (SP-D), and pulmonary function, including vital capacity (VC) and diffusing capacity for carbon monoxide (DLco), were collected. IgG and IgA antibodies against avian antigens were detected using enzyme-linked immunosorbent assay (ELISA) as previously described [27]. Each polystyrene plate well (Immulon 2; Dynatech Laboratories Inc., Alexandria, VA, USA) was coated with 100 μL of 1 μg/mL pigeon dropping extract (PDE) in a carbonate buffer (pH 9.6) overnight at 4 °C.
A nationwide epidemiological survey of chronic hypersensitivity pneumonitis in Japan
2013, Respiratory Investigation
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From athe Department of Internal Medicine, Tokyo Medicine and Dental University; bDivision of Pulmonary Medicine, Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba; and cResearch Service/151, Clement J. Zablocki Veterans Administration Medical Center and Allergy-Immunology Division, Department of Medicine, Medical College of Wisconsin, Milwaukee.
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Reprint requests: Y. Yoshizawa, MD. The First Department of Internal Medicine, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo 113, Japan.