MORTALITY IN MEXICAN PATIENTS WITH CHRONIC PIGEON BREEDER LUNG COMPARED WITH THOSE WITH USUAL INTERSTITIAL PNEUMONIA

The clinical course of chronic pigeon breeder's lung (CPBL) is unknown , especially in comparison with usual interstitial pneumonia (UIP). We studied a cohort of 125 consecutive patients with interstitial lung d iseases, including 78 patients with CPBL (74 biopsied) and 47 patients with UIP in the lung biopsy. Patients with UIP were divided into 17 w ithout bird exposure (UIP) and 30 with bird exposure (UIP + BE). All p atients were treated with corticosteroids and followed for 33 +/- 23 m onths. The best predictors of mortality (Cox proportional hazards mode l) were age > 44 yr, with a relative risk (RR) of 2.5 and 95% confiden ce interval (Cl) of 1.4 to 4.7, masculine gender (RR 4.0, Cl 2.1 to 7. 6), x-ray honeycombing (RR 7.0, Cl 3.8 to 12.7), and severity of fibro sis in the lung biopsy (RR 4.8, Cl 2.3 to 9.7). Survival in CPBL 5 yr after diagnosis was 0.71 (SEM 0.08) and in UIP was 0.23 (SEM 0.08), wi th no statistical difference between UIP + BE and UIP. After adjusting for severity of fibrosis and honeycombing, however, the correlation o f diagnosis with survival disappeared. In conclusion, mortality in CPB L is considerable, but lower than in UIP. Lung fibrosis and honeycombi ng seem to be a final common pathway for the ILD. Adjusting for them, the effect of diagnosis in survival is not significant.