Hypersensitivity pneumonitis secondary to lovebirds: a new cause of bird fancier's disease.

Détails

ID Serval
serval:BIB_48014D41378B
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Hypersensitivity pneumonitis secondary to lovebirds: a new cause of bird fancier's disease.
Périodique
European Respiratory Journal
Auteur(s)
Funke M., Fellrath J.M.
ISSN
1399-3003[electronic]
Statut éditorial
Publié
Date de publication
2008
Volume
32
Numéro
2
Pages
517-521
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article -
Résumé
Hypersensitivity pneumonitis (HP) is an immunologically mediated lung disease due to the repetitive inhalation of antigens. Most new cases arise from residential exposures, notably to birds, and are thus more difficult to recognise. The present authors report a 59-yr-old male who complained of dyspnoea and cough while being treated with amiodarone. Pulmonary function tests revealed restriction and obstruction with low diffusing lung capacity for carbon monoxide and partial pressure of oxygen. A high-resolution computed tomography chest scan and bronchoalveolar lavage showed diffuse bilateral ground-glass attenuation and lymphocytic alveolitis, respectively. Initial diagnosis was amiodarone pulmonary toxicity, but because of a rapidly favourable evolution, this diagnosis was questioned. A careful environmental history revealed a close contact with lovebirds shortly before the onset of symptoms. Precipitins were strongly positive against lovebird droppings, but were negative against other avian antigens. The patient was diagnosed with hypersensitivity pneumonitis to lovebirds. Avoidance of lovebirds and steroid treatment led to rapid improvement. The present observation identifies a new causative agent for hypersensitivity pneumonitis and highlights the importance of a thorough environmental history and of searching for precipitins against antigens directly extracted from the patient's environment. These two procedures should allow a more precise classification of some cases of pneumonitis, and thus might avoid progression of active undiagnosed hypersensitivity pneumonitis to irreversible fibrosis or emphysema.
Mots-clé
Agapornis, Alveolitis, Extrinsic Allergic/complications, Alveolitis, Extrinsic Allergic/diagnosis, Amiodarone/metabolism, Animals, Antigens/metabolism, Bird Fancier's Lung/complications, Bird Fancier's Lung/diagnosis, Blood Gas Analysis, Cough, Humans, Male, Middle Aged, Precipitins/diagnostic use, Radiography, Thoracic, Tomography, X-Ray Computed
Pubmed
Web of science
Open Access
Oui
Création de la notice
14/10/2009 13:41
Dernière modification de la notice
08/05/2019 18:02
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