Background: Feather duvet lung (FDL) is a rare subgroup of bird fancier’s lung. It is caused by inhalation of organic dust due to goose or duck feathers in duvets or pillows. Methods: A retrospective review of the medical records of 13 patients with FDL was performed to assess the specific history and review clinical characteristics of patients with this disease. Results: All patients were female with a mean age of 53 years (26–71). They were recently exposed to feather duvets (6), pillows (1) or both (6). Specific histories were duvets or pillows filled with raw goose feathers from their own farms (4), intensive contact with goose feathers in youth (3), and bird exposure prior to symptom onset (5). In all patients specific IgG antibodies to goose and/or duck feathers were detected. Pulmonary function tests revealed a moderate to severe reduced diffusion capacity and a mild restrictive pattern. High-resolution computed tomography was performed in 11 patients and demonstrated predominantly ground-glass opacities (10) and fibrosis (6). In bronchoalveolar lavage fluid, lymphocytic alveolitis was demonstrated in all patients. Lung biopsies were obtained in 9 patients and demonstrated lymphocytic alveolitis (8), granulomas (3), bronchiolitis obliterans organizing pneumonia pattern (2), and usual interstitial pneumonia pattern (1). Conclusions: The clinical findings of FDL are typical of extrinsic allergic alveolitis. Primary sensitization could be due to former exposure to bird antigens at home or goose/duck feather exposure in youth. In view of the increasing popularity of feather duvets, FDL should be considered in the differential diagnosis of patients with extrinsic allergic alveolitis.

Patel AM, Ryu JH, Reed CE: Hypersensitivity pneumonitis: current concepts and future questions. J Allergy Clin Immunol 2001;108:661–670.
Lacasse Y, Selman M, Costabel U, Dalphin JC, Morell F, Erkinjuntti-Pekkanen R, Mueller NL, Colby TV, Schuyler M, Jomphe V, Cormier Y: Classification of hypersensitivity pneumonitis. A hypothesis. Int Arch Allergy Immunol 2009;149:161–166.
Terho EO: Diagnostic criteria for farmer’s lung disease. Am J Ind Med 1986;10:329.
Richerson HB, Bernstein L, Fink JN, Hunninghake GW, Novey HS, Reed CE, Salvaggio JE, Schuyler MR, Schwartz HJ, Stechschulte DJ: Guidelines for the clinical evaluation of hypersensitivity pneumonitis. J Allergy Clin Immunol 1989;84:839–844.
Schuyler M, Cormier M: The diagnosis of hypersensitivity pneumonitis. Chest 1997;111:534–536.
Sennekamp J, Müller-Wening D, Amthor M, Baur X, Bergmann KC, Costabel U, Kirsten D, Koschel D, Kroidl R, Liebetrau G, Nowak D, Schreiber J, Vogelmeier C: Guidelines for diagnosing extrinsic allergic alveolitis. German Extrinsic Allergic Alveolitis Study Group. Pneumologie 2007;61:52–56.
Lacasse Y, Selman M, Costabel U, Dalphin JC, Ando M, Morell F, Erkinjuntti-Pekkanen R, Müller N, Colby TV, Schuyler M, Cormier Y, HP Study Group: Clinical diagnosis of hypersensitivity pneumonitis. Am J Respir Crit Care Med 2003;168:952–958.
Selman M: Hypersensitivity pneumonitis: a multifaceted deceiving disorder. Clin Chest Med 2004;25:531–547.
Ohtani Y, Saiki S, Sumi Y, Inase N, Miyake S, Costabel U, Yoshizawa Y: Clinical features of recurrent and insidious chronic bird fancier’s lung. Ann Allergy Asthma Immunol 2003;90:604–610.
Ohtani Y, Saiki S, Kitaichi M, Usui Y, Inase N, Costabel U, Yoshizawa Y: Chronic bird fancier’s lung: histopathological and clinical correlation. An application of the 2002 ATS/ERS consensus classification of the idiopathic interstitial pneumonias. Thorax 2005;60:665–671.
Sennekamp HJ: Bird breeder’s lung; in Sennekamp HJ (ed): Extrinsic Allergic Alveolitis/Hypersensitivity Pneumonitis, ed 1. Munich, Dustri Verlag, 2004.
Meyer FJ, Bauer PC, Costabel U: Feather wreath lung: chasing a dead bird. Eur Respir J 1996;9:1323–1324.
Luksza AR, Bennett P, Earis JE: Bird fancier’s lung: hazard of the fishing industry. Br Med J 1985;291:1766.
Inase N, Ohtani Y, Sumi Y, Umino T, Usui Y, Miyake S, Yoshizawa Y: A clinical study of hypersensitivity pneumonitis presumably caused by feather duvets. Ann Allergy Asthma Immunol 2006;96:98–104.
Haitjema T, van Velzen-Blad H, van den Bosch JM: Extrinsic allergic alveolitis caused by goose feathers in a duvet. Thorax 1992;47:990–991.
Inase N, Sakashita H, Ohtani Y, Sogou Y, Sumi Y, Umino T, Usui Y, Yoshizawa Y: Chronic bird fancier’s lung presenting with acute exacerbation due to use of a feather duvet. Intern Med 2004;43:835–837.
McSharry C, Dye GM, Ismail T, Anderson K, Spiers EM, Boyd G: Quantifying serum antibody in bird fancier’s hypersensitivity pneumonitis. BMC Pulm Med 2006;6:16–24.
Ouchterlony O: Handbook of Immunodiffusion and Immunoelectrophoresis, ed 1. Ann Arbor, Arbor Science Publishing, 1968, pp 4–47.
Ando M, Arima K, Yoneda R, Tamura M: Japanese summer-type hypersensitivity pneumonitis. Am Rev Respir Dis 1991;144:765–769.
Terho EO, Heinonen OP, Lammi S: Incidence of clinically confirmed farmer’s lung disease. Am J Ind Med 1986;10:330.
Bergmann KC, Kroidl R, Liebetrau G, Müller-Wening D, Sennekamp J, Vogelmeier C: Empfehlungen zur inhalativen Provokationstestung bei exogen-allergischer Alveolitis. Arbeitsgruppe exogen-allergische Alveolitis der Deutschen Gesellschaft für Pneumologie. Pneumologie 1998;52:444–446.
Plessner MM: A disease of feather sorters: duck fever. Arch Mal Prof 1960;21:67–69.
Burdon JGW, Stone C: Bird fancier’s lung after an unusual exposure to avian protein. Am Rev Respir Dis 1986;134:1319–1320.
Kroidl RF, Wiehammer S, Sennekamp J: Bed feathers alveolitis: 4 particular cases. Allergologie 2003;8:334–339.
Schiele R, Lutgen W: Berufsbedingte allergische Alveolitis beim Umgang mit Bettfedern. Arbeitsmed Sozialmed Präventivmed 1978;13:36–39.
Kim KT, Dalton JW, Klaustermeyer WB: Subacute hypersensitivity pneumonitis to feathers presenting with weight loss. Ann Allergy 1993;71:19–23.
Reyes CN, Wenzel FJ, Lawton BR, Emanuel DA: The pulmonary pathology of farmer’s lung. Chest 1982;81:142–146.
Hendrick D, Marshall R, Faux J, Krall J: Positive ‘alveolar’ responses to antigen inhalation provocation tests: their validity and recognition. Thorax 1980;35:415–427.
Vogelmeier C, Krombach F, Münzing S, König G, Mazur G, Beinert T, Fruhmann G: Activation of blood neutrophils in acute episodes of farmer’s lung. Am Rev Respir Dis 1993;148:396–400.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.