Severien C, Artlich A, Jonas S
Klinik für Pädiatrie der Medizinischen Universität zu Lübeck.
Klin Padiatr. 1998 Nov-Dec;210(6):413-7. doi: 10.1055/s-2008-1043914.
Pigeon breeder's disease is a common form of hypersensitivity pneumonitis, which is rarely diagnosed in children. We report a seven year old boy, who developed cough, easy fatigue, anorexia and weight loss over a period of two months after having contact with pigeons. The findings on physical examination were tachypnoea and reduced thoracic movements. Chest radiograph showed widespread fine nodular shadowing in both lung fields. Pulmonary function tests demonstrated a restrictive defect and an impaired diffusion. Lymphocytes were highly increased in bronchoalveolar lavage (BAL) fluid. Precipitating antibodies against pigeon excreta was found in the serum. Environmental control of pigeon protein and a course of systemic corticosteroids over 4 months resulted in clinical and lung function improvement. However clinical recovery stopped over several months after discontinuation of steroid therapy. Therefore steroid therapy was reinstalled and continued until complete clinical recovery and pulmonary function occurred, that was 20 months after onset of the disease. Essential for the patient was to avoid further contact with birds. However a prolonged steroid therapy was necessary to achieve complete resolution. Lung function tests were useful for follow up and decisions on further treatment.
鸽饲养者病是一种常见的过敏性肺炎，在儿童中很少被诊断出来。我们报告一名7岁男孩，在接触鸽子两个月后出现咳嗽、易疲劳、厌食和体重减轻。体格检查发现呼吸急促和胸廓活动度降低。胸部X线片显示双肺野广泛的细小结节状阴影。肺功能测试显示为限制性缺陷和弥散功能受损。支气管肺泡灌洗（BAL）液中的淋巴细胞显著增加。血清中发现针对鸽排泄物的沉淀抗体。对鸽蛋白进行环境控制并进行4个月的全身皮质类固醇治疗后，临床症状和肺功能得到改善。然而，在停用类固醇治疗几个月后，临床恢复停止。因此，重新开始并持续使用类固醇治疗，直到临床完全恢复和肺功能恢复，即疾病发作后20个月。对患者来说，避免进一步接触鸟类至关重要。然而，需要长期使用类固醇治疗才能完全康复。肺功能测试有助于随访和决定进一步治疗方案。
