[Allergic alveolitis due to inhalation of avian proteins (author's transl)]

Allergic alveolitis is the immunologic response of the alveolar wall and the interstitial spaces of lung to inhalation of different organic, antigenic substances. This paper presents the case of a 12 1/2-year old girl with a pulmonary disease caused by inhalation of protein contained in the excrement dust from budgerigars. In the paat few years several reports already described this disease in breeders of pigeons and budgerigars. During some years our patient had recurrent episodes of a subacute illness with severe cough, dysponea, cyanosis of lips, tachycardia, and weakness. Auscultation showed only discrete crepitant rales at both lung bases. In contrast the chest roentgenogram demonstrated marked changes with soft fine patchy densities and reticulation dispersed through the lung parenchyma. The histological examination of lung biopsy showed a thickening of alveolar walls and of interstitial spaces with lymphocytic infiltration, fibrosis, and multinuclear giant cells. In accordance with this findings pulmonary function tests revealed a restriction and a decrease in diffusing capacity; furthermore there was a middle-grade obstruction. The presence of precipitating antibodies in the serum against extracts of excrements from budgerigars confirmed the relation between pulmonary disease and domestic allergen. Our experience indicates that perferential therapy is the avoidance of contact with birds.