[The sequential changes of the serum levels of KL-6, SP-D, and DLCO were followed for a long term in a case of acute bird fancier's lung].Arerugi. 2009 Oct; 58(10):1433-40.A
The sequential changes of the serum levels of KL-6, SP-D, and DLco were followed for a long term in a case of acute bird fancier's lung, A 52 years-old-male was admitted to our hospital because of cough, dyspnea on exertion and fever. He has been breeding 12 pigeons in home for the last five years. HRCT of the chest demonstrated diffuse centrilobular nodules and ground-glass opacities with mosaic pattern in bilateral lung fields. Bronchoalveolar lavage (BAL) showed an increased number of lymphocytes with a increased CD4/CD8 ratio, and transbronchial lung biopsy (TBLB) specimen revealed alveolitis with infiltration of lymphoid cells and Masson body in the air spaces. He was diagnosed as having bird fancier's lung because of the elevated antibodies against pigeon dropping extracts (PDE) in the serum and BALF. Respiratory failure continued after complete avoidance of contact with pigeons for a week. Clinical symptoms and chest X-ray findings improved markedly after administration of steroid, and he left the hospital to move into a new house. The serum levels of KL-6 and SP-D were unchanged by antigen avoidance, although those were returning to normal gradually after treatment of steroid. SP-D and KL-6 returned to normal in 8 months and 18 months respectively and DLco was also improved slowly in parallel with a decrease of these markers. These results suggest that the serum KL-6 level and DLco reflect the disease activity showing gradual recovery of alveolitis in such a long period.