Hypersensitivity pneumonitis or bird fancier’s diseasesis caused by inflammation and allergic reaction in the lungs’parenchyma due to exposure to proteins from birds.
Cause of bird fancier’s disease:
The bird fancier’s disease develops due to antigens exposure from either feathers or bird droppings or sometime from serum exposure. The exposure can be variable in term of intensity or duration and the type of birds. The person who may develop this disease may not be aware of actual exposure which may be coming from the ventilation system.
Symptoms and signs:
Patient with bird fancier’s disease generally present with dry cough for many months to years along with the breathlessness and chest tightness. Generally, there is no significant mucus production. There may be some weight loss as disease progresses and patients may develop leg swelling as disease progresses further. There may be obvious exposure to birds or it may be quite inconspicuous.
Incidence:
Hypersensitive pneumonitisis a rare disease and it its incidence can vary from one person per 100,000 population per year to 10/ 100,000 population per year.
Diagnosis:
Diagnosis of hypersensitivity pneumonitis is made on basis of typical clinical features, features on CT scan of the lungs along with the breathing tests. CT scan shows inflammation and scarring/fibrosis and there is a reduced lung function on a breathing test. There may be obvious exposure history. Sometimes, we may do blood tests to confirm the possible immunological linkage.
Treatment:
The treatment of hypersensitivity pneumonitis requires complete avoidance to the antigen and birds. It is important to understand that exposure which may not be obvious and feather products may be present in the pillow or in the doona..
Complications:
If hypersensitive pneumonitis or bird fancier’s disease left untreated and there is ongoing exposure to the antigen, it can become progressive and causes irreversible scarring of the lungs and debilitating symptoms associated with it.
It is important to diagnose this condition as early as possible. It needs completion avoidance of exposure. Sometimes anti-inflammatory medication or antifibrotic medication can be used though these are not FDA approved yet.
Australian Polyclinic,
CCA Phase 5 DHA, Lahore
0311 057 3333
Dr G Sarwar Chaudhry
MBBS (King Edward Medical College)
Fellow Royal Australasian College of Physicians (FRACP Australia)
Fellow American College of Chest Physicians (FCCP)
Conjoint Lecturer, University of Newcastle, NSW, Australia
Consultant Pulmonologist and Sleep Physician
Consultant General Physician www.australianpolyclinic.com
