Pigeon breeder's lung in childhood: Varied clinical picture at presentation

Extrinsic allergic alveolitis occurs rarely in childhood. We present 5 case s and briefly review the literature regarding this condition in the pediatr ic population. This report includes all cases (n = 5) of extrinsic allergic alveolitis known to have occurred in childhood on Malta. All cases were ma les, and were initially misdiagnosed as having other respiratory illnesses or mental disturbances. The diagnosis was based on a history of exposure to birds, clinical findings, positive avian precipitins, a restrictive defect on pulmonary function tests, and a suggestive chest X-ray appearance. All were treated with high-dose oral steroids for 3-4 weeks, with excellent res ponse. Although these patients appear to have suffered no long-term sequela e, delayed diagnosis can lead to irreversible pulmonary fibrosis. The diagn osis of extrinsic allergic alveolitis should be entertained early in the di fferential diagnosis of children presenting with unusual respiratory sympto ms and signs. (C) 2000 Wiley-Liss, Inc.