Chest
Clinical InvestigationsLongitudinal Pulmonary Function Changes in Pigeon Breeders
Section snippets
METHODS
Eleven symptomatic and 42 asymptomatic pigeon breeders were initially identified and were entered, with consent, into a study during a 1967 survey of pigeon racing clubs in Utah.7 The symptomatic subjects were defined as having had acute hypersensitivity pneumonitis based on a history of systemic symptoms (chills, fever, sweating, cough and malaise) following exposure to pigeons on at least two occasions. No subacute or chronic cases were identified when members of this group were examined in
DATA ANALYSIS
Means and percent predicted values of the pulmonary measurements made in 1985 for these symptomatic and asymptomatic subjects were calculated. All measurements of each parameter for all subjects in each subgroup were separately regressed against age to test for significant average declines.12 Parameters showing significant declines with age were further tested by comparing the slope of the decline for the symptomatic and asymptomatic groups of pigeon breeders to the slope of the normal decline
RESULTS
Twelve subjects were lifetime nonsmokers and three were ex-smokers at the beginning of the study. One of these breeders (subject 11) resumed smoking cigarettes and had a 48 pack-year history by 1985 and one (subject 9) resumed smoking a pipe. Except for exposure to pigeons, the occupational and environmental exposure history of the 15 subjects was otherwise unremarkable (Table 1).
Six of the seven symptomatic and seven of the eight asymptomatic subjects had precipitating antibodies to pigeon
DISCUSSION
This study demonstrates that symptomatic pigeon breeders with ongoing antigen exposure experience declines in FVC, FEV1 and Dsb that are three to four times normal (Table 3; Figure 1, Figure 2, Figure 3). The same functional parameters decline at normal rates in asymptomatic pigeon breeders. Since cross-sectional studies tend to overestimate the rate of decline, the declines observed in symptomatic breeders are even more pronounced when compared to longitudinal predictions.13, 14
In the absence
ACKNOWLEDGMENTS
The authors appreciate the technical assistance of the Pulmonary Laboratories of the LDS Hospital and Salt Lake Clinic, and of Steven Berlin, Debbie Crews, Harriet May and Beth Jarman in the collection of data and preparation of this manuscript.
REFERENCES (25)
- et al.
Farmers lung: clinical, pathologic and immunological study of twenty-four patients
Am J Med
(1964) - et al.
Pigeon breeders' lung
JAMA
(1965) Hypersensitivity pneumonitis
Postgrad Med
(1972)- et al.
Pigeon breeders' disease: a clinical study of hypersensitivity pneumonitis
Ann Intern Med
(1968) Pulmonary hypersensitivity disease due to inhaled organic antigens
Ann Intern Med
(1966)- et al.
Pulmonary function in pigeon breeders' disease: a hypersensitivity pneumonitis
Ann Intern Med
(1969) - et al.
Bird breeder's hypersensitivity pneumonitis: progress studies of lung function after cessation of exposure to the provoking antigen
Am Rev Respir Dis
(1976) - et al.
Pigeon breeders' disease: a prevalence study and review
Clin Allergy
(1975) - et al.
Clinical pulmonary function testing
(1975) - et al.
Standardized single breath normal values for carbon monoxide diffusing capacity
Am Rev Respir Dis
(1981)
Reference spirometric values using techniques and equipment that meet ATS recommendations
Am Rev Respir Dis
Lung volumes in healthy non-smoking adults
Bull Europ Physiopathol Respir
Cited by (35)
Chronic Hypersensitivity Pneumonitis
2012, Clinics in Chest MedicineCitation Excerpt :In pigeon breeders, a long-term follow-up study of almost 20 years compared symptomatic with asymptomatic pigeon breeders. Symptomatic pigeon breeders had a 3- to 4-fold increase in the expected proportional decrease of FEV1 and FVC with increasing age, whereas the group of asymptomatic pigeon breeders showed no difference compared with a healthy control population.74 In bird breeder’s lung, the prognosis was found to be excellent.
Hypersensitivity Pneumonitis and Eosinophilic Pulmonary Diseases
2006, Kendig's Disorders of the Respiratory Tract in ChildrenDiseases of the Lung and Pleura
2005, Textbook of Clinical Occupational and Environmental MedicineThe effect of pulmonary fibrosis on survival in patients with hypersensitivity pneumonitis
2004, American Journal of MedicineCitation Excerpt :Some suggest that avian hypersensitivity pneumonitis is associated with a worse prognosis; however, we found no association between antigen type and outcome. In patients with acute farmers' lung, continued antigen exposure does not appear to affect lung function, whereas in patients with pigeon breeders' lung, duration of exposure before diagnosis affects response to therapy and disease progression (4,5,29–33). The lack of an association between antigen type and mortality may reflect several potential limitations of our study.
The long-term outcome in acute, subacute, and chronic forms of pigeon breeder's disease hypersensitivity pneumonitis
2002, Annals of Allergy, Asthma and ImmunologyTomodensitométrie haute résolution des alvéolites allergiques extrinsèques
1995, Revue francaise d'allergologie et d'immunologie clinique
Supported in part by grants from Salt Lake Clinic Research Foundation and the Intermountain Allergy and Immunology Clinic.