Bird fancier's lung
ICD-10 J67.2 · ICD-11 CA70.2

Treatment of Bird Fancier's Lung in Hypersensitivity Pneumonitis with Pulmonary Fibrosis on HRCT

Clinical Scenario

This protocol applies to patients with bird fancier's lung who have hypersensitivity pneumonitis (HP) with radiological evidence of pulmonary fibrosis on HRCT — including reticulation, traction bronchiectasis, and honeycombing. This pattern places the patient in the fibrotic HP phenotype, which carries distinct prognostic and treatment implications.

Why This Presentation Matters

International diagnostic guidelines now recommend classifying HP as fibrotic or nonfibrotic based on the presence or absence of radiological and/or histopathological fibrosis. In bird fancier's lung, ongoing avian antigen exposure is associated with further lung function decline, making active exposure status a critical factor in management.

Management Approach

The initial step centres on identifying and eliminating the active causative exposure. For avian-associated HP, specific environmental measures address the source directly.

The complete structured regimen — including the full sequence of interventions, adjunctive considerations, and monitoring targets — is available in the full protocol.

Clinical Goal

The primary target is improvement in lung function following removal of the causative exposure.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/resp.14847

  1. Patients with HP may also display features of fibrosis, including reticulation, traction bronchiectasis and honeycombing (Figure 2B).
  2. Recently published international diagnostic guidelines recommend HP classification into fibrotic or nonfibrotic phenotypes based on the presence or absence of radiological and/or histopathological fibrosis, supported by the observation that pulmonary fibrosis conveys important prognostic and treatment implications.
  3. The initial step in the management of HP is identification and avoidance of active causative exposures.
  4. Examples include a change in role or location for workplace exposures, and complete removal of birds, feathers and droppings, as well as a deep clean of soft furnishings for avian-associated HP.
  5. Ongoing exposure is associated with further lung function decline, and removal of exposure may result in improvement.
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