Centre for Pulmonary Diseases and Thoracic Surgery, Department of Pulmonary Diseases, Fachkrankenhaus Coswig, Germany.
Int Arch Allergy Immunol. 2010;152(3):264-70. doi: 10.1159/000283036. Epub 2010 Feb 12.
Feather duvet lung (FDL) is a rare subgroup of bird fancier's lung. It is caused by inhalation of organic dust due to goose or duck feathers in duvets or pillows.
A retrospective review of the medical records of 13 patients with FDL was performed to assess the specific history and review clinical characteristics of patients with this disease.
All patients were female with a mean age of 53 years (26-71). They were recently exposed to feather duvets (6), pillows (1) or both (6). Specific histories were duvets or pillows filled with raw goose feathers from their own farms (4), intensive contact with goose feathers in youth (3), and bird exposure prior to symptom onset (5). In all patients specific IgG antibodies to goose and/or duck feathers were detected. Pulmonary function tests revealed a moderate to severe reduced diffusion capacity and a mild restrictive pattern. High-resolution computed tomography was performed in 11 patients and demonstrated predominantly ground-glass opacities (10) and fibrosis (6). In bronchoalveolar lavage fluid, lymphocytic alveolitis was demonstrated in all patients. Lung biopsies were obtained in 9 patients and demonstrated lymphocytic alveolitis (8), granulomas (3), bronchiolitis obliterans organizing pneumonia pattern (2), and usual interstitial pneumonia pattern (1).
The clinical findings of FDL are typical of extrinsic allergic alveolitis. Primary sensitization could be due to former exposure to bird antigens at home or goose/duck feather exposure in youth. In view of the increasing popularity of feather duvets, FDL should be considered in the differential diagnosis of patients with extrinsic allergic alveolitis.
羽绒肺（FDL）是鸟类爱好者肺的一个罕见亚组。它是由于吸入羽绒或枕头中的鹅或鸭羽毛等有机尘埃而引起的。
对 13 例 FDL 患者的病历进行回顾性分析，以评估该疾病患者的具体病史和临床特征。
所有患者均为女性，平均年龄 53 岁（26-71 岁）。她们最近接触过羽绒被（6 例）、羽绒枕头（1 例）或两者均接触过（6 例）。具体病史包括羽绒被或枕头填充有来自自家农场的生鹅毛（4 例）、年轻时与鹅毛密切接触（3 例）以及在发病前有鸟类接触史（5 例）。所有患者均检测到针对鹅和/或鸭羽毛的特异性 IgG 抗体。肺功能检查显示弥散能力中度至重度降低和轻度限制性模式。11 例患者进行了高分辨率计算机断层扫描，显示主要为磨玻璃样混浊（10 例）和纤维化（6 例）。所有患者的支气管肺泡灌洗液中均显示淋巴细胞性肺泡炎。9 例患者获得了肺活检，显示淋巴细胞性肺泡炎（8 例）、肉芽肿（3 例）、闭塞性细支气管炎伴机化性肺炎模式（2 例）和普通间质性肺炎模式（1 例）。
FDL 的临床发现是外源性过敏性肺泡炎的典型表现。初次致敏可能是由于在家中曾接触过鸟类抗原，或在年轻时接触过鹅/鸭羽毛。鉴于羽绒被越来越受欢迎，对于外源性过敏性肺泡炎患者，应考虑 FDL 的鉴别诊断。
