Author:
Stiehm E. Richard,Reed Charles E.,Tooley William H.
Abstract
Diffuse interstitial pneumonitis associated with the prolonged exposure to pigeons is described in five boys ages 7 to 15. The clinical characteristics include a gradual onset of cough, shortness of breath, and weight loss; in three cases, acute onset of fever, chills, cough, and muscle aches occurred within 12 hours after heavy exposure. Physical findings consisted only of occasional rales and wheezes. The chest x-rays in four cases showed a diffuse interstitial pneumonitis. A lung biopsy in one case disclosed interstitial inflammation, round cell infiltration, and giant cell formation. The patients improved when the birds were removed. One severely ill boy was treated successfully with steroids.
Pulmonary function studies disclosed diminished vital capacity, absent or minimal airway obstruction, and a variable defect in diffusing capacity. Their sera contained normal or elevated complement levels, increased γG and γA globulin, and precipitating antibody to extracts of pigeon feathers, droppings, and plasma. Levels of precipitating antibody, measured by a new radial diffusion technique, tended to correlate with the severity of the disease and the degree of exposure to pigeons. Antibody levels fell progressively when pigeons were removed from the environment.
Except that the specific antigens differ, pigeons breeder's lung, Farmer's lung, bagassosis, maple bark stripper's disease and other similar syndromes are identical. They all differ sharply from allergic bronchial asthma in the symptoms and the mechanisms of the hypersensitivity. The histopathology of the biopsy, the elevated serum complement, and the absence of disease in some exposed individuals who have precipitins favor the interpretation that the pathogenesis of this illness is a delayed hypersensitivity to the inhaled antigens; but participation of an Arthus-type reaction cannot be excluded.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics, Perinatology and Child Health
Cited by
8 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
1. Hypersensitivity Pneumonitis;Pediatric Pulmonology;2023-11-17
2. Pediatric hypersensitivity pneumonitis: literature update and proposal of a diagnostic algorithm;Italian Journal of Pediatrics;2022-03-28
3. Hypersensitivity Pneumonitis;A Clinical Guide to Occupational and Environmental Lung Diseases;2012
4. Die Mikrolithiasis;Pädiatrische Pneumologie;1985
5. Exogene allergische Alveolitis im Kindesalter;Ergebnisse der Inneren Medizin und Kinderheilkunde / Advances in Internal Medicine and Pediatrics;1982