Feather duvet lung.
BACKGROUND
Bird fancier's lung (BFL) is a type of hypersensitivity pneumonitis, which is induced by inhalation of bird related antigens. The diagnosis of BFL induced by feathers is difficult because feathers are generally not recognized as a causative antigen of BFL. We report a female case of chronic BFL presumably due to a feather duvet, which presents as pulmonary fibrosis.


METHODS
A 73 year-old woman presented with exertional dyspnea for the last three years. She had raised two pigeons for three years (1971-1973) in her forties and had been using a feather duvet for the last eight years (1992-2000). A chest X-ray showed reticular infiltrates in the both peripheral lung field and an HRCT scan showed scattered consolidation, micronodules, and peribronchial ground-glass opacities. Lymphocyte proliferation to the feather antigen was positive and inhalation provocation test using a bird antigen was also positive. Thoracoscopic biopsy specimens showed organization, cholesterol clefts, alveolitis around terminal and respiratory bronchioles--all of which are consistent with chronic hypersensitivity pneumonitis. Clinical findings have spontaneously improved after she stopped using her feather duvet.


CONCLUSIONS
Feather beds including duvets, pillows, and cushions are now popular all over the world. Physicians should be aware of feathers as a cause of BFL since this induction seems to be more prevalent.
Inase
Naohiko
N
The Pulmonary Medicine, Tokyo Medical and Dental University Tokyo, Japan.
Ohtani
Yoshio
Y
Endo
Junji
J
Miyake
Shuji
S
Yoshizawa
Yasuyuki
Y
D000368:Aged; D000818:Animals; D001512:Bedding and Linens / Q000009:adverse effects*; D001716:Bird Fancier's Lung / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D001985:Bronchial Provocation Tests; D002908:Chronic Disease; D005241:Feathers / Q000276:immunology*; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D008213:Lymphocyte Activation