Document Detail


Inhalation provocation tests in chronic bird fancier's lung.
MedLine Citation:
PMID:  11083690     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with chronic bird fancier's lung (BFL) can be classified into two types. One group of patients develops chronic disease with fluctuating acute episodes, including low-grade fever, mild exertional dyspnea, and cough (fluctuating chronic BFL; formerly termed recurrent and relapsing chronic BFL). The other group of patients shows no history of acute episodes (insidious chronic BFL). The diagnosis of chronic BFL is difficult, since the onset of chronic BFL may be insidious, with few if any symptoms during the early stages of the disease process. Study objective: To attempt to diagnose the conditions of these patients more precisely, inhalation provocation tests were conducted using avian dropping extracts. DESIGN: Retrospective chart review. SETTING: The Tokyo Medical and Dental University Hospital in Japan. PATIENTS: Eleven patients with chronic BFL (6 with fluctuating chronic BFL and 5 with insidious chronic BFL) and 6 control subjects (4 asymptomatic bird owners and 2 idiopathic pulmonary fibrosis patients) were evaluated. Measurements and results: Inhalation provocation tests using avian dropping extracts were conducted. All BFL patients were evaluated as positive or probable by inhalation challenge, whereas control subjects were evaluated as negative. A peripheral leukocytosis, an increase of alveolar-arterial oxygen pressure difference, an increase of body temperature, and the development of respiratory symptoms including cough and dyspnea were more frequently observed in chronic BFL patients than in control subjects. All the BFL patients had an increase in neutrophils in BAL fluids following inhalation challenge. CONCLUSIONS: We validated the utility of inhalation challenge for the diagnosis of chronic BFL, including fluctuating and insidious BFL. We also demonstrated that neutrophilia in BAL fluids following inhalation challenge could be added to the diagnostic criteria for chronic BFL.
Authors:
Y Ohtani; K Kojima; Y Sumi; M Sawada; N Inase; S Miyake; Y Yoshizawa
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  Chest     Volume:  118     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-11-29     Completed Date:  2000-12-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1382-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Pulmonary Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Allergens / diagnostic use
Bird Fancier's Lung / classification,  diagnosis*,  physiopathology
Body Temperature / physiology
Bronchial Provocation Tests* / methods
Bronchoalveolar Lavage Fluid / cytology
Chi-Square Distribution
Chronic Disease
Cough / physiopathology
Disease Progression
Dyspnea / physiopathology
Female
Fever / physiopathology
Humans
Leukocytosis / diagnosis
Male
Middle Aged
Neutrophils / pathology
Predictive Value of Tests
Pressure
Pulmonary Fibrosis / diagnosis
Pulmonary Gas Exchange / physiology
Retrospective Studies
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Allergens

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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