The late bronchus-obstructive response to bronchial challenge with pigeon faeces and its correlation with precipitating antibodies (IgG) in the serum of patients having long-term contact with pigeons.

Abstract

From a total of 160 patients with allergic bronchial asthma or chronic asthmatic bronchitis, eighteen (11.3%) patients reported being regularly exposed to pigeons. In these eighteen patients, bronchial provocation tests with pigeon faeces were performed and the precipitating antibodies (IgG) in their serum against pigeon faeces and serum were estimated. Of the eighteen patients, seven (39%) demonstrated a 'late bronchus-obstructive response' to pigeon faeces. Three patients developed only an 'isolated late response' and in the other four patients the late response occurred as a part of the 'dual response'. In the seven patients with the positive late bronchial response, the precipitating antibodies in their serum to pigeon faeces were positive in five (71%) and to pigeon serum in two (28%) of them. The late skin responses to pigeon faeces were positive in five (71%) patients, the blood eosinophilia increased in six (86%) of them, a slight pyrexia occurred in two (28%) and general malaise symptoms appeared in six (86%) of them. None of these patients developed changes on the chest X-ray during the late response. The remaining eleven patients did not develop any bronchial response to pigeon faeces challenge, although in six (55%) of them the late skin responses were positive, and two (18%) had precipitating antibodies in the serum to pigeon faeces and one (9%) to pigeon serum. It is concluded that positive precipitating antibodies in the serum to pigeon faeces and serum are important parameters for detection of pigeon breeder's disease in exposed individuals, however confirmation of this diagnosis should be provided by the bronchial provocation tests.