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Pigeon breeder's lung in childhood: is family screening necessary?
Naci Ceviz1, Hasan Kaynar, Haşim Olgun
1Division of Pediatric Cardiology, Atatürk University School of Medicine, Erzurum, Turkey. nceviz@atauni.edu.tr
Insights
Pigeon breeder's lung (PBL) can affect families, including asymptomatic members. Early diagnosis via screening and prompt steroid treatment can resolve interstitial lung disease and pulmonary hypertension.
Area of Science:
- Pulmonology
- Immunology
- Radiology
Background:
- Pigeon breeder's lung (PBL) is a hypersensitivity pneumonitis.
- Familial cases of PBL are rarely reported.
- PBL can present with diverse clinical and radiological manifestations.
Purpose of the Study:
- To describe the clinical and laboratory findings of PBL in a mother and her children.
- To highlight the importance of family screening and HRCT in diagnosing PBL.
- To emphasize the effectiveness of steroid treatment in PBL.
Main Methods:
- Case series reporting clinical and laboratory findings.
- High-resolution computerized tomography (HRCT) for diagnosing interstitial lung disease.
- Treatment with steroid therapy.
Main Results:
- PBL diagnosed in a mother and her two children, presenting with chronic recurrent and chronic insidious forms.
- Index case initially diagnosed with primary pulmonary hypertension, later identified as PBL.
- Asymptomatic sister diagnosed with interstitial lung disease via HRCT during family screening.
- All affected individuals showed complete resolution of HRCT findings after three months of steroid treatment.
Conclusions:
- PBL should be considered in patients with acute respiratory symptoms and resolving pulmonary hypertension.
- Family screening using HRCT is crucial for detecting interstitial lung disease in asymptomatic relatives.
- Steroid treatment is effective in managing PBL and reversing HRCT abnormalities.
Abstract:
In this paper, we report on clinical and laboratory findings of pigeon breeder's lung (PBL) in a mother and her 2 children: 2 with the chronic recurrent form, and 1 with the chronic insidious form without any symptoms or signs, who was diagnosed during family screening. The index case was diagnosed as having primary pulmonary hypertension on admission. However, on evaluation, the diagnosis was of pigeon breeder's lung in the index case and her symptomatic mother. High-resolution computerized tomography (HRCT) revealed interstitial lung disease in an asymptomatic sister of the index case. All cases responded to steroid treatment, and at the end of the third month, HRCT findings disappeared. In conclusion, in patients with acute respiratory symptoms and rapidly recovering pulmonary hypertension after hospitalization, PBL should be remembered. All family members of the index case should be screened by HRCT in terms of interstitial lung disease, even if they are asymptomatic.
