What Is Pigeon Breeders Lung Disease?
Pigeon breeders lung disease is an immunological or hypersensitive lung disease caused by repeated exposure to air-borne avian antigens; it commonly affects children and workers who are exposed to the avian antigens; the condition is very common but still is generally misdiagnosed due to its rare rate of occurrence, though being rare the disease is a severe cause of breathlessness in people who are repeatedly exposed to such antigens including the professional workers and children in and around the area. The condition is mild initially but if the exposure continues leads to chronic irreversible stages.
Other Names:
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Extrinsic allergic alveolitis.
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Bird fancier's lung.
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Pigeon breeder or pigeon fancier disease.
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Farmer's lung.
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Bat lung.
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Animal handler's lung.
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Laboratory worker's lung.
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Miller's lung.
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Lycoperdonosis.
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Hot tub lung.
What Are the Causes of Pigeon Breeders Lung Disease?
The disease is caused by repeated exposure to avian antigens; these antigens can be of any bird-like pigeon, parakeet, parrot, chicken, etc., which are released as dry dust with the dropping of the feathers, as the human body is sensitive to such antigens. When these are inhaled, an immune reaction or hypersensitivity reaction is launched against these antigens as they contain mucins and antibodies, which leads to inflammation of the lungs and can cause granuloma in the later stages of the disease. The disease is manifested in various stages, called acute or subacute. People repeatedly exposed to such antigens, like professional workers, pet store workers, and bird lovers, are at a higher risk of acquiring the disease.
What Are the Symptoms of Pigeon Breeders Lung Disease?
Some of the common symptoms are as follows:
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Cough.
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Chills.
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Shortness of breath.
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Chest tightness.
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Weight loss.
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Dyspnea (the medical term meaning shortness of breath or trouble breathing).
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Lack of appetite.
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Fatigue.
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Pulmonary fibrosis (a disorder that causes scarring of the lungs over time).
The symptoms presented are similar to any allergic reaction, and these symptoms vein within 24 hours after the exposure is ceased. Still, chronic cases continue to suffer even after the causative agent is avoided. The symptoms do not appear immediately after exposure. The disease progresses slowly over a period of time, the first symptom of granuloma formation appears after exposure for about 1.6 years, and the disease acquires its chronic stage in the span of 16 years. Though the patients experience breathlessness and discomfort, the disease has a low mortality rate, but the chronic cases are fatal. The condition is complicated by pulmonary fibrosis, which develops over time and leads to respiratory failure or diffuse alveolar damage.
How Is Pigeon Breeders Lung Disease Diagnosed?
The disease is diagnosed symptomatically, and it is very important to obtain the patient's complete history to confirm the diagnosis. To differentiate the condition from other similar disorders, a patient can be exposed to a similar protein, and if the reaction is presented, the diagnosis is confirmed. The chronic cases of the disease in advanced stages might require advanced radiological examination, which includes:
- X-Rays: These X-rays show a typical ground glass appearance, which is a sign of lung damage.
- Bronchoscopy: In the advanced stage presents, inflammatory changes in the lungs.
- Biopsy: When a section is taken and studied under the microscope, lymphocytosis, and granulomatous tissue are observed.
- Peripheral Blood Smear: Lab reports show an inverted CD4, CD8 ratio, which indicates lymphocytosis.
How Is Pigeon Breeder's Lung Disease Treated?
Treatment mainly aims at irradiating the causative agent; therefore, people who are allergic to avian proteins are advised to stay away from the birds; such patients should also avoid visiting bird reserves or wildlife sanctuaries.
Other treatment modalities include removing avian protein: avoiding avian protein in any form as it triggers the condition is recommended. People allergic to them should remove all the birds, bedding, pillows, soft toys, wall hangings, or anything that contains feathers. After everything is removed, it is good to wash all the belongings and the house to clean any remaining feathers in order to prevent further episodes. In extreme cases, even the patients might have to evacuate their houses and dispose of all the belongings which are difficult to clean. Even the family and people staying around must take precautions and not go near the patient without cleaning themselves thoroughly whenever they come in contact with the birds. The symptoms would still remain, and the recovery time would vary depending on the underlying damage.
Steroids:
Corticosteroids are administered in these patients to suppress the symptoms; these medications, like Prednisone, are effective only during the initial episodes of the disorder. Later, the symptoms are difficult to control even with higher doses of corticosteroids; therefore, staying away from the avian protein is the only way to protect from preventing the symptoms. During the early stages of the disease, corticosteroids prevent inflammation and prolong fibrosis of the lungs.
The prognosis of the disease is good if the lungs have not undergone any fibrosis and the symptoms improve within a few hours of removal of the causative agent. The patients' conditions improve totally, but the symptoms return when they are exposed to the allergen again.
Conclusion
Pigeon breeder's lung disease is a rare disorder found in individuals allergic to avian protein; anybody can be affected by this. These protein damages the lungs leading to irreversible fibrosis, and thus, a patient presents with respiratory symptoms like dry cough, breathlessness, chest tightness, and dyspnea. The progressive stages of the disease also cause weight loss and reduced appetite. These can be caused by the feathers or the bedding made from feathers of any bird-like pigeon, chicken, etc.; therefore, people who experience such symptoms are recommended to avoid going near such objects or birds. The disease is manifested clinically in its early stages. Still, the advanced stages or the diagnosis is based on various laboratory tests like blood smear, biopsy, etc. The disease is not fatal if preventive and precautionary measures are followed but can be life-threatening if avian protein exposure is not avoided. Fibrosis of the lungs is the major complication seen in these patients.
