Güngör Sinem, Bilgin Sevinç, Akbaba Belma, Yalçinsoy Murat, Akkaya Esen
Süreyyapaşa Chest Diseases and Chest Surgery Educational and Training Hospital, Istanbul, Turkey.
Tuberk Toraks. 2007;55(1):103-7.
Bird fancier's lung disease (BFLD) is a hypersensitivity pneumonia which develops in response to organic bird products. Two patients (25 y/M, 43 y/F) were admitted to our clinic with complaints of dyspnea, fewer and weight loss, both had history of pigeon exposure and we investigated them for BFLD. First patient had restrictive pulmonary function tests with DLCO of 49%, and the second patient had obstructive pulmonary function tests with DLCO of 33%. HRCT of both patients revealed nodular infiltrations. With these findings and history of pigeon exposure (the first patient at his job, the second patient at home) the diagnosis of BFLD was established. First patient had complete remission after removal of pigeons from the environment. Initial inhaled corticosteroid and later systemic corticosteroid therapy was given to second patient. In conclusion, if BFLD, a rare disease, is considered initially in the differential diagnosis and environmental exposure is evaluated, the diagnosis and treatment is possible.
养鸟人肺疾病(BFLD)是一种因接触有机鸟类产物而引发的超敏性肺炎。两名患者(25岁男性、43岁女性)因呼吸困难、咳嗽及体重减轻前来我院就诊,两人均有接触鸽子史,我们对其进行了养鸟人肺疾病调查。首例患者肺功能测试显示为限制性通气功能障碍,弥散功能(DLCO)为49%,第二例患者肺功能测试显示为阻塞性通气功能障碍,弥散功能为33%。两名患者的高分辨率CT(HRCT)均显示有结节状浸润。结合这些检查结果以及接触鸽子史(首例患者在工作场所接触,第二例患者在家中接触),确诊为养鸟人肺疾病。首例患者在避免接触鸽子后完全缓解。第二例患者最初接受吸入性糖皮质激素治疗,之后接受全身性糖皮质激素治疗。总之,如果在鉴别诊断初期考虑到养鸟人肺疾病这种罕见疾病并评估环境暴露情况,就有可能进行诊断和治疗。