A Case of Progressive Respiratory Failure Resulting from Chronic Bird Fancier's Disease after Postoperative Chemotherapy

SHINOHARA Yoko, KIYOKI Yusuke, ANDO Keita, OKAWA Tyuta, YAMANA Takashi, NISHIYAMA Naoki, KAWAKAMI Naoki, WAKAI Yoko, YAMASHITA Takaaki, SAITO Kazuhito, ONUKI Takuya, INAGAKI Masaharu

doi:10.2185/jjrm.65.62

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肺腺癌術後補助化学療法後の経過中に増悪を認めた慢性鳥飼病の１例
症例報告肺腺癌術後補助化学療法後の経過中に増悪を認めた慢性鳥飼病の1例
ショウレイホウコクハイセンガンジュツゴホジョカガクリョウホウゴノケイカチュウニゾウアクオミトメタマンセイドリシビョウノ 1レイ

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Abstract

75-year-old man had the right lower lobe resected because of pulmonary adenocarcinoma (stage IIB) and received 4 courses of postoperative chemotherapy 4 years earlier. Thereafter, he continued to complain of cough, sputum, and progressive exertional breathlessness. The preoperative chest CT showed ground glass opacity (GGO) at the bottom of both lung fields, and over time the GGO changed to honeycombing with traction bronchiectasis. He was administered prednisolone, clarithromycin, and pirfenidone but with little improvement. He exhibited hypoxemia (PaO₂ 56 mmHg) and was admitted. An interview revealed that he had worked in the poultry farming business for 45 years having had contact with and breeding 3,000 game fowl at the time of hospitalization. We suspected bird-related hypersensitivity pneumonitis. Results of the reaction to pigeon dropping extracts (PDE) were high, with PDE IgG 0.697 and PDE IgA 0.445. He was diagnosed with chronic bird-related hypersensitivity pneumonitis. Although the chest CT appearance was difficult to distinguish from that of idiopathic interstitial pneumonia, the test for PDE and the interview were useful for reaching a diagnosis.

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JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE

JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE 65 (1), 62-69, 2016

THE JAPANESE ASSOCIATION OF RURAL MEDICINE

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