The aim of the study was to assess the degree of airways involvement in non-smoking subjects with extrinsic allergic alveolitis resulting from pigeon-derived antigens. Two hundred and eight pigeon fanciers completed a questionnaire of symptoms, performed spirometry on a Vitalograph Compact spirometer and had IgG antibody to pigeon γ-globulin measured. Eighty fanciers had the acute form of pigeon fanciers' lung (PFL) and these subjects were less likely to be current smokers (P <0.001). Subjects with PFL had a higher prevalence of chronic bronchitis (P <0.001), large airways (P= 0.014) and peripheral airways obstruction (P <0.001). The prevalence of chronic bronchitis and peripheral airways obstruction increased significantly as the level of antibody to pigeon γ-globulin rose. Peripheral airways obstruction, as manifest by a reduced FEF25–75%, was the most common abnormality found. Airways disease is an important feature of the acute form of PFL and consists of a hypersecretory disorder in the form of chronic bronchitis and of obstructive airways disease particularly affecting the peripheral airways.
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