title: [Bird-related chronic hypersensitivity pneuminitis demonstrating the fluctuation of disease activity accompanied with environmental changes].
abstract: We report a case of bird-related chronic hypersensitivity pneuminitis exhibiting the fluctuation of serum markers for interstitial lung disease along with the changes in life environment. A 65-year-old man had had an abnormal chest radiograph for 2 years and had complained of a non-productive cough. He had had 30 parakeets 20 years previously and had used feather products for 15 years. In autumn and early winter wild birds had visited persimmons trees in the neighboring garden. Antibodies to bird-related antigens in the broncho-alveolar lavage fluids and sera were positive and the thoracoscopic lung biopsy specimens histologically revealed airway-centered fibrosis. We then determined he was having bird-related chronic hypersensitivity pneumonitis. After avoidance of feather products, all of serum SP-A, SP-D and KL-6 decreased. But three markers elevated and radiographic findings worsened accompanied with the increase of visiting wild birds in next autumn. After pruning persimmon trees and starting corticosteroid with cyclosporine, disease activity gradually improved.
authors.affiliation: Division of Respiratory Medicine, Department of Medicine, National Defense Medical College.
authors.forename: Yuu
authors.initials: Y
authors.lastname: Hara
authors.forename: Hideo
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Hisayuki
authors.initials: H
authors.lastname: Osoreda
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kanoh
authors.forename: Kazuo
authors.initials: K
authors.lastname: Motoyoshi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ozeki
mesh_terms: D000368:Aged; D000818:Animals; D001512:Bedding and Linens; D001716:Bird Fancier's Lung / Q000503:physiopathology*; D001717:Birds / Q000276:immunology; D006801:Humans; D008297:Male