A Pigeon Fancier’s Lung; Subacute on Chronic Hypersensitivity Pneumonitis

Pigeon fancier’s lung, a form of hypersensitivity pneumonitis (HP), is a rare but important occupa­tional and recreational preventable cause of severe and debilitating breathlessness. We report a case of a 44-year-old Sri Lankan lady presenting with pro­gressive severe breathlessness due to pigeon fan­cier’s lung. She has bred pigeons for 20 years. She was hypoxemia at rest. There were reticular nodular opacities and diffuse ground glass opacities, inter- and intralobular thickening with subpleural sparing on high resolution imaging. She had marked im­provement to glucocorticoid pulses. We diagnosed this patient as subacute on chronic HP considering clinical and radiological evidence. Avoidance of al­lergen and steroids advised with regular follow up to monitor progression.