title: The long-term outcome in acute, subacute, and chronic forms of pigeon breeder's disease hypersensitivity pneumonitis.
abstract: BACKGROUND
  Pigeon breeder's disease (PBD) is an avian-induced hypersensitivity pneumonitis. The limited data that exist on the long-term outcome for the disease are conflicting.
  
  
  OBJECTIVE
  We sought to determine the long-term outcome of patients with PBD to evaluate the course of the disease.
  
  
  METHODS
  Review a case series of 18 pigeon breeders that were followed from 4 to 26 years after initial diagnosis.
  
  
  RESULTS
  Fourteen breeders reduced their bird contact significantly; four kept their birds. In eight patients with the acute form of the disease, pulmonary function either did not change from normal or improved to normal. Of five patients with subacute disease, four had persistent symptoms. All had mildly abnormal spirometry with either restrictive or obstructive changes which persisted. Five patients with chronic disease exhibited daily dyspnea. They had severe abnormalities of lung function at diagnosis. Of these patients, three improved and two deteriorated. Chest radiographs were of little value in predicting outcome.
  
  
  CONCLUSIONS
  Patients with the acute form of PBD have the best prognosis, compared with those with subacute and chronic forms. Although some improvement could be seen in most individuals, recovery may still not be complete. Those with the chronic form are at particular risk for morbidity.
authors.affiliation: Medical College of Wisconsin, Milwaukee, USA. mzacharisen@chw.org
authors.forename: Michael C
authors.initials: MC
authors.lastname: Zacharisen
authors.forename: Donald P
authors.initials: DP
authors.lastname: Schlueter
authors.forename: Viswanath P
authors.initials: VP
authors.lastname: Kurup
authors.forename: Jordan N
authors.initials: JN
authors.lastname: Fink
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000542:Alveolitis, Extrinsic Allergic / Q000145:classification / Q000503:physiopathology*; D000818:Animals; D001716:Bird Fancier's Lung / Q000145:classification / Q000503:physiopathology*; D002648:Child; D002908:Chronic Disease; D010856:Columbidae / Q000276:immunology; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011379:Prognosis; D012129:Respiratory Function Tests