Abstract
Five cases of hypersensitivity pneumonitis from doves and/or pidgeons in children presented within a 8 month period. Patients were 11 to 15 years of age; there were 2 females and 3 males. The diagnosis in all patients was confirmed by the presence of precipitating antibody to dove or pigeon serum and/or droppings. Clinical improvement was noted in all patients after exposure to the birds ceased.
Although hypersensitivity pneumonitis is generally considered to occur primarily in non-atopic individuals, 3 of our 5 patients had histories suggestive of atopy.
While HP can occur as an acute, intermittent systemic and respiratory illness, all of these patients developed insidious and progressive respiratory disease; 3 had profound weight loss.
The children were followed for up to 3 years after initial diagnosis, with interval history, physical exam, serum precipitins, nasal smears, skin tests, pulmonary function studies and methacholine challenges.
On follow-up evaluations, 4 out of 5 patients had continuing respiratory disease and 1 had bronchial hyperreactivity with a strongly positive methacholine test. One of the patients continues to have precipitating antibody to avian antigen 3 years after termination of exposure.
Early identification of HP is important to avoid the development of chronic pulmonary disease with progressive pulmonary fibrosis.
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Marshall, S., Pierson, W., Shapiro, G. et al. UNIQUE FEATURES OF HYPERSENSITIVITY PNEUMONITIS IN CHILDREN. Pediatr Res 18 (Suppl 4), 397 (1984). https://doi.org/10.1203/00006450-198404001-01824
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DOI: https://doi.org/10.1203/00006450-198404001-01824