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Fatal diffuse alveolar damage from bird fanciers' lung
S Tasaka1, M Kanazawa, C Kawai
1Department of Medicine, School of Medicine, Keio University, Tokyo, Japan.
Respiration; International Review of Thoracic Diseases
|January 1, 1997
Summary
Bird fancier's lung, a hypersensitivity pneumonitis, can be fatal. This case highlights acute alveolar injury in a budgerigar owner, emphasizing the severe respiratory risks associated with avian exposure.
Area of Science:
- Pulmonary Medicine
- Immunology
- Toxicology
Background:
- Bird fancier's lung, a form of hypersensitivity pneumonitis, results from chronic inhalation of avian antigens.
- Exposure to budgerigars is a known risk factor for developing this occupational lung disease.
Observation:
- A 68-year-old man with prolonged budgerigar exposure experienced progressive respiratory decline.
- Initial symptoms included airflow obstruction and reduced lung volume, evolving to pulmonary fibrosis and honeycombing on CT scans.
- The patient presented with acute respiratory failure, diffuse alveolar damage, and bronchopneumonia at autopsy.
Findings:
- Serum precipitins to pigeon antigen were detected, suggesting cross-reactivity or co-exposure.
- Autopsy confirmed widespread diffuse alveolar damage and organized exudate, indicative of acute lung injury.
- This case represents the second reported fatality from acute alveolar injury in bird fancier's lung.
Implications:
- This case underscores the potential for severe, fatal respiratory outcomes in individuals with chronic avian antigen exposure.
- Early recognition and avoidance of antigen exposure are critical for managing hypersensitivity pneumonitis.
- Further research into the mechanisms of acute alveolar injury in bird fancier's lung is warranted.