IgE-mediated reactions
Asthma, allergic rhinitis and allergic conjunctivitis may result following exposure to Canary feathers, epithelial cells or droppings (2). The allergic manifestations may present as Bird Fancier´s Asthma and as Bird-Egg Syndrome, with symptoms such as rhinitis, urticaria and angioedema (3)(2) and also as gastro-intestinal problems (4). Specific IgE has been found in patients exposed to Canary (1, 3, 4).
In a study, IgE antibodies to Canary were present in about 25% of the bird fanciers investigated (2). Among 212 sera from Budgerigar and Canary fanciers with symptoms of rhinitis and/or bronchial asthma, in 25 of 98 Canary feather-specific IgE antibody measurements, a significant level of specific IgE was found. In 3 sera IgE antibodies against sera from both birds were present. Canary feathers were shown to contain IgE-binding antigens that were not present in the bird sera and droppings (5).
In a prospective study, 258 adults were investigated for sensitisation against bird antigens (Budgerigar, Canary, Pigeon) using an intracutaneous test. Thirty (38%) showed a positive skin reaction with at least 1 of the 3 extracts tested. In persons not exposed to birds, 24/96 (25%) were found to react to at least one of the three allergen extracts (6).
Extrinsic allergic alveolitis, also known as hypersensitivity pneumonitis, Bird Fancier's Lung and Farmer's Lung, is a disease of inflammation of the lung parenchyma in the terminal bronchioles and alveoli. Symptoms may start soon after exposure to bird allergens or after many years, and may include breathlessness, cough, occasional chills, and fever. Death may also result.
The disease occurs after exposure to organic dust, especially after close contact with Pigeons or other birds such as Budgerigars, Parrots, Canaries, Parakeets, Cockatiels, Doves and Finches. Exposure results in the development of immunoglobulin antibodies including IgE (1), IgM (8), IgA and various IgG subclasses (7-9). The antibodies may be found in the sera and saliva of patients (10) as well as in the sera of asymptomatic but exposed subjects (11).
The allergenic proteins may be found in bird serum, droppings, skin scales, feathers and, in the case of Pigeons, Pigeon bloom (a waxy fine dust which coats the feathers of Pigeons). Contact may result from handling birds, cleaning their lofts, or exposure to the organic dust drifting down from a ceiling or roof where birds nest.This is typified in a report of a 54-year-old man who presented with features consistent with extrinsic allergic alveolitis occurring after contact with his pet birds (12).Diagnosis is based on a characteristic clinical picture and a typical x-ray pattern, accompanied by the presence of specific IgG antibodies (13).The measurement of specific IgG using IgG tracer technology has been shown to be a sensitive and specific assay for the routine diagnostic testing of extrinsic allergic alveolitis (14).