Departments of Pediatric Pulmonology, Gazi University Faculty of Medicine, Ankara, Turkey.
Department of Pediatric Pulmonology, Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey.
Turk J Pediatr. 2020;62(4):623-633. doi: 10.24953/turkjped.2020.04.012.
Hypersensitivity pneumonia is a complex condition due to exposure time, intensity, different clinical presentation, and treatment practices. We aimed to evaluate the patients that were diagnosed with hypersensitivity pneumonia (HSP) due to exposure to pigeons and a review of the literature for diagnosis and treatment of Pigeon Breeder`s Disease (PBD) in children.
Between the years of 2009-2018, patients who were diagnosed with HSP due to PBD were included in the study in a pediatric pulmonology department. Findings of our patients, treatments, and prognoses were compared with 17 articles in the literature about PBD in children.
In a 9 year-period, 6 patients were diagnosed as HSP due to PBD. The mean age of the patients was 8.8 ± 5.4 years and the average duration of pigeon exposure was 60.1 ± 6.5 days. Precipitating antibodies were positive in 3 patients. In four cases, symptoms were resolved with only prevention of pigeon exposure. Two patients who had close contact with pigeons needed oxygen supplementation and steroid therapy.
Hypersensitivity pneumonia should be considered for the differential diagnosis of patients that present with respiratory distress, cough, fever, and weight loss. Prolonged exposure and close contact may worsen the clinical symptoms. In most cases, only exposure prevention is enough, while steroid therapy, oxygen support, and intensive care monitoring may be required in severe cases.
由于暴露时间、强度、不同临床表现和治疗实践的不同,过敏性肺炎是一种复杂的疾病。我们旨在评估因暴露于鸽子而被诊断为过敏性肺炎(HSP)的患者,并对儿童中鸽饲养员病(PBD)的诊断和治疗进行文献复习。
在 2009 年至 2018 年期间,在儿科肺病科,将因 PBD 而被诊断为 HSP 的患者纳入研究。将我们患者的发现、治疗和预后与 17 篇关于儿童 PBD 的文献进行了比较。
在 9 年期间,有 6 名患者因 PBD 被诊断为 HSP。患者的平均年龄为 8.8 ± 5.4 岁,鸽子暴露的平均时间为 60.1 ± 6.5 天。3 名患者的沉淀抗体呈阳性。在 4 例中,仅通过预防鸽子暴露即可使症状缓解。与鸽子有密切接触的 2 名患者需要吸氧和类固醇治疗。
对于出现呼吸窘迫、咳嗽、发热和体重减轻的患者,应考虑过敏性肺炎作为鉴别诊断。长时间暴露和密切接触可能会使临床症状恶化。在大多数情况下,仅预防暴露就足够了,而在严重的情况下,可能需要类固醇治疗、氧支持和重症监护监测。