Pigeon Serum Research Articles

Longitudinal changes in serum immunoglobulin G testing in patients with fibrotic avian hypersensitivity pneumonitis

BackgroundEvaluation of the antigen responsible for fibrotic hypersensitivity pneumonitis (HP) is challenging. Serum immunoglobulin (Ig) G testing against HP-associated antigens is performed. Although single-serum IgG testing has been investigated, multiple-serum IgG testing has not yet been studied.MethodsThis study included patients who underwent histopathological examination and positive inhalation challenge test as well as those with moderate or high HP guideline confidence level. Serum IgG testing against pigeon serum was conducted twice using two methods: enzyme linked-immunosorbent assay (ELISA) and ImmunoCAP. The association between changes in serum IgG antibody titers and changes in forced vital capacity (FVC) and other parameters was investigated.ResultsIn this study, 28 patients (mean age, 64.5 years; mean FVC, 85.3%) with fibrotic avian HP were selected, of whom 20 and 8 underwent surgical lung biopsy and transbronchial lung cryobiopsy, respectively. Of the 28 patients, 19 had been keeping birds for more than 6 months. A correlation was observed between the annual changes in serum IgG antibody titers by ELISA and changes in relative FVC (r = − 0.6221, p < 0.001). Furthermore, there was a correlation between the annual changes in serum IgG antibody titers by ImmunoCAP and changes in relative FVC (r = − 0.4302, p = 0.022). Multiple regression analysis revealed that the change in serum IgG antibody titers by both ELISA and ImmunoCAP also influenced the relative FVC change (p = 0.012 and p = 0.015, respectively). Moreover, 13 patients were given additional treatments between the first and second blood test; however, the additional treatment group was not significantly different in relative FVC change compared to the group with no additional treatment (p = 0.982).ConclusionsIn patients with fibrotic avian HP, the annual changes in serum IgG testing were correlated with FVC changes, highlighting the importance of serum IgG testing over time.

Sensitization to avian and fungal proteins in different work environments

IntroductionHypersensitivity pneumonitis (HP) is usually caused by the inhalation of avian and fungal proteins. The present study assesses a cohort of Urban Pest Surveillance and Control Service (UPSCS) workers with high exposure to avian and fungal antigens, in order to identify their degree of sensitization and the potential risk of developing HP.MethodsWorkers were divided according to their work activity into Nest pruners (Group 1) and Others (Group 2). All individuals underwent a medical interview, pulmonary function tests and the determination of specific IgG antibodies. Antigenic proteins of pigeon sera were analysed using two-dimensional immunoblotting. Proteins of interest were sequenced by liquid-chromatography–mass spectrometry (LC–MS).Results101 workers were recruited (76 men, average age: 42 yrs); (Group 1 = 41, Group 2 = 60). Up to 30% of the study population exhibited increased levels of IgGs to pigeon, small parrot and parrot, and up to 60% showed high levels of Aspergillus and Penicillium IgGs. In Group 1, specific parakeet and Mucor IgGs were higher (p = 0.044 and 0.003 respectively) while DLCO/VA% were lower (p = 0.008) than in Group 2. Two-dimensional immunoblotting showed protein bands of 20–30 KDa recognized by HP patients but not by workers. LC–MS analysis identified Ig Lambda chain and Apolipoprotein A-I as candidate proteins for distinguishing HP patients from exposed workers.ConclusionsTwo pigeon proteins were identified that may play a role in the development of pathological differences between HP patients and exposed workers. DLCO/VA may have a predictive value in the development of HP disease.

Prevalence of hypersensitive pneumonitis specific IgG antibodies in the Indian population: A retrospective study

Identifying the underlying antigen responsible for Hypersensitivity Pneumonitis (HP) in patients poses a significant challenge within the confines of a typical clinical environment. Our primary objective in this study was to investigate the distribution and prevalence of G antibodies among individuals diagnosed with HP, taking into account factors such as age, gender, and geographical location.A retrospective study spanning 5 years (from January 2018 to June 2023) was conducted, involving patients over the age of 18 who had undergone screening for HP. Data collected from 1087 patients was analysed, and the patients were categorized based on age, gender, location, and their antibody status.Out of the total cohort of 1087 patients, 62.47% were female, while 37.53% were male. The overall positivity rate for HP panel testing was determined to be 49.22%. Among the patients subjected to testing, 174 individuals (16.01%) tested positive for at least one specific antibody. Notably, among patients aged 18 to 30 years, Penicillium emerged as the most prevalent (48.28%), closely followed by fumigatus Fumigatus (44.83%). In contrast, for patients aged 31 to 45 years, Pigeon serum feathers exhibited the highest prevalence (39.69%). Moreover, the positivity rates varied across different regions in India.HP can be attributed to an array of agents commonly encountered in both workplace and home settings, encompassing microorganisms, animal and plant proteins, as well as organic and inorganic chemicals. Discerning the causative antigen not only holds immense value for physicians in optimizing patient treatment but also plays a pivotal role in pinpointing the source of exposure. Armed with this knowledge, physicians can provide patients with tailored advice to minimize their exposure risk, potentially leading to disease stabilization or even reversal. In summary, the successful identification of the etiologic antigen emerges as a formidable tool for enhancing the overall quality of patient care.

Effects of different stocking densities on organ development, blood biochemical indices, and antioxidative status of breeder pigeons during the rearing period

The present experiment was conducted to investigate the effect of different stocking densities on the organ development, blood biochemical indices, and antioxidative status of breeder pigeons during the rearing period. A total of 280 (halfmaleandhalffemale) 40-day-old young pigeons were allocated into 4 groups, including 3 experimental groups (in compartments of the flying room): the high stocking density (HSD) (0.308 m3/bird), standard stocking density (SD) (0.616 m3/bird), and low stocking density (LSD) (1.232 m3/bird) and a caged control (0.04125 m3/bird). The results showed that the contents of corticosterone and heat shock protein 70 in males and the corticosterone content in females were higher in the control than in the other groups. The relative weight of liver, lung, and gizzard in males of the HSD group was the highest among the 4 treatments, whereas the abdominal fat index in the control group was higher than those in the other 3 treatments. Body weight and the relative weight of liver and abdominal fat in female pigeons in HSD group increased significantly. The levels of serum urea nitrogen and uric acid in pigeons of LSD group increased significantly, while the concentration of total cholesterol and the activity of alanine aminotransferase were higher in the control group. Ion (K+, Ca2+, and Na+) concentrations in female pigeon serum were also elevated in the control. The activity of antioxidant enzymes, including the total antioxidant capacity, superoxide dismutase, and glutathione peroxidase in pigeon breast muscle and liver had different degrees of inhibition when the space room was crowded. Moreover, the level of malondialdehyde in the liver of male caged pigeons was higher than that in the other treatments. In summary, rearing in cages or at a high density caused stress responses in the breeder pigeons. The stocking density of breeder pigeons during the rearing period should be ranged from 0.616 m3/bird to 1.232 m3/bird.

Immunopathological Mechanisms of Bird-Related Hypersensitivity Pneumonitis.

Bird-related hypersensitivity pneumonitis (BRHP) is an interstitial lung disease induced by avian proteins. The immunopathological pathways involved in the disease are still unknown. This study assesses the cellular immune response and the cytokine pattern in a mouse model of BRHP. On days -3 and -1, mice were intraperitoneally sensitized with commercial pigeon serum (PS) or saline. Intranasal instillations with PS or saline were carried out on three consecutive days/week over either 3 weeks (Group 1) or 12 weeks (Group 2). Leukocyte and cytokine patterns in lung tissue and pulmonary inflammation in bronchoalveolar lavage (BAL) were analysed. Both groups presented increases in resident monocytes, interstitial macrophages and type 2 dendritic cells (DCs), but also reductions in inflammatory monocytes, alveolar macrophages and tolerogenic DCs compared with their control groups. Group 1 had increased levels of eosinophils and T cells with reductions in neutrophils and B cells, while Group 2 showed high levels of B cells. Both groups exhibited increases in Th1 and Th2 cytokines. Group 2 also showed increased levels of IL-23, a Th17 cytokine. Increased levels of neutrophils, eosinophils and lymphocytes were observed in BAL samples of both groups compared with controls. In the first stages of BRHP, there is a mixed Th1/Th2 immune response, while during the progression of the disease, although there is a Th1 response, the cytokine levels seem to indicate a switch towards a Th2/Th17 mixed response.

Sero-detection of antibodies to Avian metaavulavirus 2 in peri-domestic birds, Nigeria

ABSTRACT Avian metaavulavirus 2 (AMAV-2) previously known as the avian paramyxovirus-2 causes mild to severe respiratory disease, reduced hatchability and infertility of eggs, including increase in white-shelled eggs in chickens and Turkey breeders. When exacerbated by secondary pathogens and environmental stresses, infection is more severe leading to significant economic losses. This study was conducted to determine, if any, the presence of antibodies to Avian metaavulavirus 2 (AMAV-2) in peri-domestic birds in Bauchi State, Nigeria. In all, one hundred sera samples from pigeons (n = 10) and doves (n = 90 were collected in Bauchi, Nigeria. Based on hemagglutination-inhibition (HI) test, overall seroprevalence of 27.0% (27/100) was recorded. In pigeon, the seroprevalence was 80.0% while 21.1% was recorded for dove with HI antibody titers ranging from 3log2 to 8log2. There was statistical significance obtained between dove and pigeon sera tested (p < .05). Until now and to the best of our knowledge, there are no reports on AMAV-2 in poultry or wild birds in Nigeria. This study, thus, provides preliminary information on AMAV-2 seroprevalence in Nigerian peri-domestic birds. The need to conduct further studies in other avian species and wild birds in Nigeria is highlighted.

A rapid test for the environmental detection of pigeon antigen

IntroductionAvoidance of inhaled bird antigens is essential to prevent hypersensitivity pneumonitis disease progression. The aim of the present study was to develop a sandwich enzyme link immunoassay (ELISA) and an immunochromatographic test (ICT) and compare their ability to detect pigeon antigens in environmental samples. MethodsAn amplified sandwich ELISA using pigeon serum as a calibration standard and a ICT using gold-labeled anti-pigeon serum antibodies for the rapid detection of pigeon antigens in environmental samples were developed. Twenty-two different airborne samples were collected and analysed using both methods. Strip density values obtained with ICT were calculated and compared with the concentrations determined by the ELISA method for pigeon antigens. Strips results were also visually analysed by five independent evaluators. ResultsThe ELISA method to quantify pigeon antigen had a broader range (58.4 and 10,112.2 ng/ml), compared to the ICT assay (420 to 3360 ng/ml). A kappa index of 0.736 (p < 0.0001) was obtained between the observers evaluating the ICT strips. The results of the ELISA and the relative density of the ICT showed a highly significant correlation (rs:0.935; p < 0.0001). Bland-Altman plot also confirmed excellent agreement between the two methods (mean difference: −1.626; p < 0.0001). ConclusionsSince there was a good correlation between both assays, we can conclude that the rapid and simple ICT assay is a good and valid alternative, which does not require expensive equipment, for the validated ELISA technique.

REPEAT PRESENTATION OF A FEBRILE RESPIRATORY ILLNESS SECONDARY TO HYPERSENSITIVITY PNEUMONITIS

SESSION TITLE: Medical Student/Resident Occupational and Environmental Lung Disease SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Dyspnea is one of the most common reasons for presentation to the hospital. Antigen mediated lung diseases are an important cause of dyspnea however due to the wide variation in clinical presentation, the large number of possible antigens, and a lack of diagnostic tests identification can be difficult.1 Thus, a high index of suspicion must be maintained to prevent missed or delayed diagnosis. CASE PRESENTATION: A 44-year-old nonsmoker with an insignificant past medical history originally presented to an outpatient urgent care with an acute onset of fever, dyspnea, productive cough, and myalgias. He was empirically treated for bacterial pneumonia with an oral antibiotic. After initial improvement, his symptoms progressed and he ultimately presented to the emergency room with fever and worsening dyspnea. He was admitted with acute hypoxic respiratory failure and sepsis secondary to presumed post-influenza pneumonia (standard chest radiograph showed left lower lobe infiltrate). He was fluid resuscitated and received broad spectrum antibiotics. With antibiotics his fever dissipated although he continued to remain hypoxic and was discharged on hospital day seven on three liters of oxygen via nasal cannula. At hospital follow up one week later he continued to endorse dry cough and severe dyspnea (being only able to ambulate household distances with oxygen prior to having to rest). Exam was significant for crackles in the bilateral lung bases along with hypoxia (oxygen saturation dropped to 83% with removal of his nasal cannula during rest). Further history revealed the patient owned seven parakeets which were kept in the same room that the patient slept. He also endorsed unintentional 12-pound weight loss over the past 3 months. CT imaging was pursued which showed diffuse ill-defined centrilobular micronodularity and ground glass opacities throughout both lungs. Based upon this new information serum hypersensitivity pneumonitis screen was performed and ultimately returned negative for the presence of six antigens (only bird antigen on the screen was pigeon serum). Based upon the patient meeting five out of six clinical criteria for a validated clinical predication rule a diagnosis of hypersensitivity pneumonitis was established (92% Likelihood).2 He was advised to avoid further exposure to his birds and outpatient pulmonology consultation was arranged. After a short course of prednisone and avoiding further exposure the patient's symptoms resolved. DISCUSSION: Hypersensitivity pneumonitis is an important disease to keep on the differential for a patient presenting with dyspnea. CONCLUSIONS: Early diagnosis is of the upmost importance as with avoiding further exposure early lung disease can be potentially completely reversed. This case also illustrates the importance of taking a complete history and how routine use of validated clinical predication rules can help you make a diagnosis. Reference #1: 1. Riario Sforza, G.G., Marinou, A. Hypersensitivity pneumonitis: a complex lung disease. Clin Mol Allergy. 2017; 15, 6. Reference #2: 2. Lacasse Y, Selman M, Costabel U, Dalphin JC, Ando M, Morell F, Erkinjuntti-Pekkanen R, Muller N, Colby TV, Schuyler M, Cormier Y. Clinical diagnosis of hypersensitivity pneumonitis. Am J Respir Crit Care Med. 2003;168(8):952. DISCLOSURES: No relevant relationships by Catherine Cheney, source=Web Response No relevant relationships by Chris Morris, source=Web Response

Immunomodulatory effect of pigeon serum in an acute and chronic murine model of bird fanciers lung

IntroductionSince the immunopathological mechanisms of bird fancier’s lung (BFL) are not well known, we created two models of the disease (acute and chronic BFL) to study and compare the pathways involved in its immunopathogenesis. Materials and methodsC57BL/6 mice were used. Two intraperitoneal injections of 100 μL of commercial pigeon serum (PS) or saline (SAL) were administered with an interval of 48 h in between. Subsequently, intranasal instillations of 40 μL of PS or SAL were performed three days a week, for three weeks in the acute model (AC/PS) and for twelve weeks in the chronic model (CR/PS). Total lung capacity (TLC) was assessed. Pulmonary inflammation was evaluated in bronchoalveolar lavage (BAL), and total serum immunoglobulin (Ig) G was measured in serum samples 24 h, 7 days and 14 days after the last exposure. Histological studies of lungs were assessed. ResultsA drop in TLC was observed in treated mice. This decrease was more marked in the CR/PS group (p < 0.001). Neutrophil and lymphocyte counts increased in both AC/PS and CR/PS groups (p < 0.01). The extent of airway inflammation was also examined in the histological analysis of the lungs, which showed predominant perivascular and peribronchiolar inflammation, with centrilobular oedema and subpleural inflammation in the AC/PS group. In the CR/PS group, the changes were greater, with increased levels of IL-5, IL-17F, IL-13 and IL-10 and decreased levels of IL-2. ConclusionsBronchial inflammation is present in acute and chronic models of HP following exposure to PS. Our results support the role of neutrophils and IL-17 in the development of the disease and an evolution towards a Th-2 immune response in chronic HP. These models may serve as a tool for future studies of the pathogenesis of HP.

Serosurvey of West Nile virus in household-reared pigeons in Bauchi metropolis, Nigeria.

In Nigeria not much is known about West Nile virus (WNV) in pigeons. This study determined the involvement of household-reared pigeons in the circulation of WNV in Nigeria. It was a cross-sectional study. Serological detection was done using competitive enzyme-linked immunosorbent assay and a pretested interviewer-administered questionnaire was used to collect information on risk factors related to WNV in households. From the156 households enumerated, 376 pigeon serum samples were collected and tested for antibodies. A total of 3.5% (13/376) of the pigeon sera were positive. Risk factors for WNV in households indicated that not having a blocked or stagnant gutter that is not flowing, and having mosquito nets at the windows and doors were found to be protective (OR=0.69, 95% CI, 0.21-2.29; OR=0.46, 95% CI, 0.14-1.56). Household-reared pigeons contribute to the epidemiology of WNV. There is need for further studies in other species of birds, and education of the populace about its zoonotic transmission.

USEFULNESS OF LYMPHOCYTE STIMULATION TEST AGAINST PIGEON SERUM IN MANAGEMENT OF PATIENTS WITH CHRONIC HYPERSENSITIVITY PNEUMONITIS

RespirologyVolume 22, Issue S3 p. 256-256 APSR Poster Abstracts USEFULNESS OF LYMPHOCYTE STIMULATION TEST AGAINST PIGEON SERUM IN MANAGEMENT OF PATIENTS WITH CHRONIC HYPERSENSITIVITY PNEUMONITIS First published: 23 November 2017 https://doi.org/10.1111/resp.13207_453Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume22, IssueS3Supplement: 22nd Congress of the Asian Pacific Society of Respirology, International Convention Centre, Sydney, Australia, 23–26 November 2017November 2017Pages 256-256 RelatedInformation

Protein antigen of bird-related hypersensitivity pneumonitis in pigeon serum and dropping

BackgroundAvian antigen is a common cause of hypersensitivity pneumonitis (HP). Inhalation challenge with pigeon serum and pigeon dropping extract (PDE) elicits a hypersensitivity reaction in patients with bird-related hypersensitivity pneumonitis (BRHP), but the antigenic components in these materials have yet to be fully elucidated.MethodPigeon serum, pigeon intestine homogenates, and PDE were immunoblotted with serum samples from 8 patients with BRHP, 2 patients with summer-type HP, 2 patients with humidifier lung, and 3 healthy volunteers. Among the protein spots found in both pigeon serum and PDE, those that reacted with sera from BRHP patients were identified by mass spectrometry. Immunoassays using recombinant protein were performed to confirm the antigenicity of the identified protein. Cytokine production by peripheral blood mononuclear cells (PBMCs) stimulated with recombinant protein was also assessed.ResultsImmunoglobulin lambda-like polypeptide-1 (IGLL-1) was identified from all spots on 2-DE immunoblots of both pigeon serum and PDE. The BRHP patients exhibited higher levels of serum IgG antibody against the recombinant IGLL-1 (rIGLL-1) compared to the control subjects, as well as a stronger PBMCs proliferative response to rIGLL-1. Cytokine production by PBMCs from BRHP patients after rIGLL-1 exposure indicated that the protein could induce Th1 prone immune responses: an increase in TNF-α and an absence of elevated IL-10 production.ConclusionsPigeon IGLL-1 was identified as the BRHP antigen present in both pigeon serum and PDE.

A Lady and Her Bird

SESSION TITLE: Student/Resident Case Report Poster - Occupational and Environmental Lung Diseases SESSION TYPE: Student/Resident Case Report Poster PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM INTRODUCTION: Hypersensitivity pneumonitis (HP) is a broad characterization of interstitial lung disease caused by immune reactions to inhaled agents. Known offending agents include agricultural dust, aerosolized contaminated water, bird droppings, and mold, among others. Diagnosis is made when clinical suspicion is high, and with the aid of high-resolution CT scan, bronchioalveolar lavage (BAL), lung biopsy, and at times, antigenic panels. CASE PRESENTATION: A fifty-one-year-old woman with history of poorly-controlled asthma was referred to pulmonology clinic for evaluation of chronic cough and wheezing. Initial work-up included a chest x-ray revealing prominent interstitial markings, an elevated IgE level and a negative anti-nuclear antibody. The patient was started on Spiriva without improvement. Computed tomography of the chest was performed, displaying interstitial lung disease, concerning for HP. Upon further questioning, the patient had an indoor pet bird, further strengthening the suspicion for HP. An HP panel (aspergillus fumigatus, micropolyspora faeni, thermoactinomyces vulgaris, aurebasidium pullilans, thermoactinomyces sacchari, and pigeon serum) was negative, however, causing the patient to question the underlying etiology of her symptoms.The patient was instructed to remove the bird from her house, but was hesitant to do so given her negative HP panel. To rule out other etiologies, bronchoscopy with BAL was performed. Results yielded elevated lymphocyte and eosinophil counts, but negative cultures. These findings were consistent with a diagnosis of HP. At follow-up, the patient’s clinical course had deteriorated and she required supplemental oxygen. The patient was treated with steroids, and was again instructed to remove the bird from her home. Reluctantly, the patient did so. One month later, the patient’s chronic respiratory symptoms had improved. She no longer required supplemental oxygen. DISCUSSION: Hypersensitivity pneumonitis is a severe, but reversible, cause of interstitial lung disease. The utility of antigenic panels in the diagnosis of HP is controversial. It has been shown that these panels can be useful if one chooses appropriate antigens for the geographical region of interest. However, it has also been shown that a positive antigenic panel does not correlate with symptoms of HP. In this case, the use of an antigenic panel was detrimental to the treatment of the patient, as it led to questioning of the diagnosis and inciting allergen. This led to a delay in the primary treatment of this condition, which is removal of the offending agent. CONCLUSIONS: Antigenic panels can be useful, provided they contain pertinent antigens to the geographic region or animal of interest, but these tests must be considered within the context of the entire patient case, when diagnosing HP. Reference #1: Spagnolo P, Rossi G, Cavazza A, Bonifazi M, et al. Hypersensitivity Pneumonitis: A Comprehensive Review. J Investi Allergol Clin Immunol. 2015; vol.25(4):237-250 DISCLOSURE: The following authors have nothing to disclose: Ross Humes, Whittney Warren, Erik Osborn No Product/Research Disclosure Information

Environmental challenge: An effective approach for diagnosis and remediation of exacerbations of hypersensitivity pneumonitis

Environmental challenge: An effective approach for diagnosis and remediation of exacerbations of hypersensitivity pneumonitis

Immune complex disease in guinea pig lungs: elicitation with pigeon serum.

Immune complex- and T cell-mediated reactions to organic antigens appear to contribute to the pathogenesis of hypersensitivity pneumonitis in humans. Because pigeon serum is one of the reagents used by clinicians to diagnose this disease, we assessed its potential to elicit immune complex-mediated pulmonary inflammation in guinea pigs. Animals were immunized with different concentrations of pigeon serum protein emulsified in complete Freund's adjuvant, and serums were collected at 4-day intervals after the booster injection. The largest amounts of tissue-fixing (IgG1) and complement-fixing (IgG2) antibodies to pigeon serum were detected in guinea pigs immunized with 1.0 mg of pigeon serum protein 20 to 24 days after the secondary immunization. Therefore, the responses of these animals and of recipients of serum from these animals to aerosol challenge with either homologous (pigeon serum) or heterologous (bovine gamma globulin) immunogen was investigated. Actively and passively immunized guinea pigs developed pulmonary inflammation only after exposure to aerosolized pigeon serum. However, lesions were not observed in the lungs of complement-deficient recipients of immune serum that had inhaled homologous immunogen. These observations suggest that such pigeon serum-elicited pulmonary inflammation in guinea pigs is a manifestation of a complement-dependent, humoral-immune mechanism of pathogenesis and thus is consistent with an immune complex disease.

Severe Haemolytic Anaemia Secondary To Avian Allergy

Summary We present the first case of pigeon allergy causing severe haemolytic anaemia. Serology demonstrated very high titres of antibodies to avian proteins; in excess of those seen in the majority of cases of allergic lung disease1. Observation, immunosuppressive therapy and attempts at reducing antigen exposure were ineffective in controlling the disease. The only effective measure was culling the birds which resulted in a swift remission in the patient’s illness. Background Avian allergic diseases are well documented including extrinsic allergic alveolitis and asthma. However, from a review of the literature, haemolytic anaemia has not yet been described. Case Presentation An eight year old boy presented to accident and emergency with malaise, pallor and a sore throat. Haemoglobin was 53g/L. Further clinical examination revealed splenomegaly of 3.5cm below the costal margin. Investigations Full blood count demonstrated marked anaemia and a reticulocytosis (Hb 53g/L, WBC 2.2 x109/L, Neuts 1.3 x109/L, Lymphs 0.6 x109/L, Platelets 186 x109/L, Reticulocytes 375 x109/L). Blood film demonstrated increased polychromasia and microspherocytes. Direct coombes test was negative. Differential Diagnosis The patient’s haemoglobin stabilised following a short period of time in hospital. Red blood cell transfusion and immunosuppressive therapy were not required at this stage. Despite stable haemoglobin concentrations there continued to be evidence of haemolysis throughout the first year of follow-up. This was complicated by gallstone disease which required open cholecystectomy. School attendance was adversely affected. In view of the prolonged duration of the illness the patient was screened for congenital and acquired causes of haemolysis. No cause was found for the condition. Three years later the patient experienced decompensated haemolysis with a fall in his haemoglobin to 66g/L and symptoms of lethargy and malaise. His splenomegaly was more marked at 5.0cm. He was commenced on prednisolone (1mg/kg) which stabilised his blood count but was complicated by psychiatric disturbances. During a routine follow-up appointment the patient disclosed that he kept over 100 racing pigeons at his home. He was involved in their care on a daily basis and would regularly race the birds in competitions. Serological testing demonstrated high titres of antibodies to avian proteins (pigeon and budgie serum, feather and droppings &gt;200x103 mg/L). These levels are in excess of those seen in the majority of cases of allergic lung disease1. Treatment Initial attempts to reduce exposure were ineffective. Following discussions with the family the birds were culled. There was an immediate and dramatic effect on reticulocytes and within a month it was possible to begin reducing the steroid dose. Over the following year there was a progressive rise in his haemoglobin associated with a continued fall in the reticulocytosis. Steroids were discontinued at four months. Three years following the removal of the causative agent the patient remains well and off treatment. Discussion Avian proteins are commonly cited as a cause for immune conditions, predominantly those affecting the respiratory system. This is the first case of avian allergic haemolytic anaemia. This case highlights the importance of consideration of unusual pathologies. Competing interests None Patient consent Not obtained. References 1) C I Baldwin, A Todd, J E Calvert. Pigeon fanciers' lung: effects of smoking on serum and salivary antibody responses to pigeon antigens. Clin Exp Immunol. 1998 Aug;113(2):166-72. Disclosures: No relevant conflicts of interest to declare.

Cloning and expression of a truncated pigeon circovirus capsid protein suitable for antibody detection in infected pigeons

Infections with pigeon circovirus (PiCV) (also termed columbid circovirus) occur in meat and racing pigeons (Columba livia) of all ages and have been reported worldwide. A PiCV infection is associated with immunosuppression and the development of young pigeon disease syndrome. An indirect enzyme-linked immunosorbent assay (ELISA) for the detection of virus-specific serum antibody was developed for research purposes. In the absence of a method to propagate PiCV in cell culture, the assay was based on a recombinant truncated capsid protein (rCapPiCV) produced by overexpression in Escherichia coli. A 6×His-Tag was fused to the N-terminus of the protein to facilitate purification by metal affinity chromatography and detection by anti-His antibody. PiCV-negative and PiCV-positive control sera were generated by inoculation of pigeons with tissue homogenate containing PiCV, followed by five weekly blood sample collections. Western blotting of the immune serum revealed a specific protein band of approximately 32 kDa, which was absent in the pre-immune sera. Using rCapPiCV as antigen in an indirect ELISA, PiCV-specific antibody was detected in sera of the experimentally PiCV-infected pigeons collected at 1 to 5 weeks post infection. By testing 118 field sera collected in the years 1989, 1991, 1994 and 2008 in the rCapPiCV ELISA, virus-specific antibody was detected in 89 (75%) of the sera. The results obtained demonstrate that the rCapPiCV-based indirect ELISA is able to detect PiCV-specific antibodies in pigeon sera and may be a useful tool for PiCV serodiagnosis.

Pulmón del cuidador de palomas

Bird fancier's or breeder's lung is an unusual hypersensitivity pneumonitis found in pediatric patients, due to avian antigen inhalation. A case of pigeon breeder's lung in a 12 years old child is presented. Clinical symptoms were dry cough for 15 days, dyspnea and weight loss. Physical examination of the patient showed cyanosis, chest tightness, tachypnea, inspiratory crackles and oxygen saturation of 91% in room air. Laboratory data revealed hypergammaglobulinemia and elevated LDH. Pulmonary function testing showed a mixed ventilatory pattern and a decreased carbon monoxide diffusion (DLCO) capacity. Radiological findings were compatible with hypersensitivity pneumonitis, and pigeon IgG antibodies (ELISA) and skin tests with pigeon serum were positive. The child improved with corticoid therapy and antigen avoidance.

Immunoglobulin and antibody levels in bronchoalveolar lavage fluid from symptomatic and asymptomatic pigeon breeders

Twenty-one symptomatic subjects with pigeon breeders' lung (PBL) and 10 asymptomatic pigeon breeders, with a similar exposure to pigeon antigens, underwent bronchoalveolar lavage. Total IgG, IgM and IgA in lavage fluid were determined as were specific antibody levels against antigens in pigeon serum and droppings. Results were converted to levels in epithelial lining fluid (ELF) using lavage and serum urea ratios. It was found that symptomatics represent a group that is hyperreactive to pigeon antigens compared with the asymptomatic group with significantly higher IgG, IgM, IgA levels as well as specific antibody levels against pigeon serum and droppings. Paired serum and ELF samples from 12 symptomatic subjects showed significantly elevated IgG, IgM and IgA levels in ELF compared with serum when values were expressed in terms of albumin. This strongly supports the concept of local production of immunoglobulins within the lung after inhaling immunogens as opposed to their diffusion from the vasculature. Results for IgA indicate that any putative protective role for this immunoglobulin is not valid in relation to the prevention of extrinsic allergic alveolitis. Analysis of smoking habits, lung immunoglobulins and response to inhalation challenge confirm the negative influence of smoking on total and functional lung immunoglobulins; however, levels in the ELF of ex-smokers suggest that the effect of smoking is not permanent. Smoking did not prevent responses to inhalation challenge.

Inhibition of Protein Binding in Hypersensitivity Pneumonitis with Pigeon Serum and Bird Excrement Extracts

Inhibition of Protein Binding in Hypersensitivity Pneumonitis with Pigeon Serum and Bird Excrement Extracts