Liu-Shiu-Cheong Patrick, Kuo Chris RuiWen, Wilkie Struan Wa, Dempsey Owen
Respiratory Medicine, Victoria Hospital, Kirkcaldy, UK.
Respiratory Medicine, Aberdeen Royal Infirmary, Aberdeen, UK.
BMJ Case Rep. 2019 Nov 18;12(11):e231237. doi: 10.1136/bcr-2019-231237.
A 43-year-old non-smoker was referred with a 3-month history of malaise, fatigue and breathlessness. Blood avian precipitins were strongly positive. Lung function testing confirmed a restrictive pattern with impaired gas transfer. A 'ground glass' mosaic pattern was seen on CT imaging, suggestive of hypersensitivity pneumonitis. Although he had no pet birds, on closer questioning he had recently acquired a duvet and pillows containing feathers. His symptoms, chest radiograph and lung function tests improved after removal of all feather bedding, and he was also started on oral corticosteroid therapy. Our case reinforces the importance of taking a meticulous exposure history and asking about domestic bedding in patients with unexplained breathlessness. Prompt recognition and cessation of antigen exposure may prevent the development of irreversible lung fibrosis.
一名43岁的不吸烟者因3个月的不适、疲劳和呼吸急促症状前来就诊。血液中禽沉淀素呈强阳性。肺功能测试证实存在限制性模式，气体交换受损。CT成像显示出“磨玻璃”样马赛克图案，提示过敏性肺炎。尽管他没有宠物鸟，但经进一步询问，他最近购买了含有羽毛的羽绒被和枕头。去除所有含羽毛的床上用品后，他的症状、胸部X光片和肺功能测试都有所改善，同时他也开始接受口服皮质类固醇治疗。我们的病例强调了在不明原因呼吸急促的患者中仔细询问接触史并询问家用床上用品情况的重要性。及时识别并停止抗原接触可能会预防不可逆肺纤维化的发展。
