Goose feathers

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Code: e70
Latin name: Anser anser
Source material: Feathers and serum proteins
Family: Anatidae
Common names: Goose, Toulouse Goose, Grey Goose, Greylag
The genera Anser and Branta should both be considered. Anser includes many wild Geese with well-known domestic relatives. This group includes Anser anser (European) and species of Africa and Asia. Branta includes wild Geese like the Canada Goose (Branta Canadensis) and the Brants (most notably Branta bernicla).
 
Direct or indirect contact with bird allergens may cause sensitisation. Bird allergens may be major components of house dust.

Allergen Exposure

Geographical distribution
Goose is the common name for large wild and domesticated swimming birds related to the Duck and the Swan. (Strictly speaking, the term Goose is applied to the female and gander to the male.) Wild Geese tend to be seasonally migratory, moving in large flocks over great distances between continents.
 
Environment
Geese are found in agricultural settings, and in aquatic and semi-aquatic environments in the wild. Their meat is eaten roasted and broiled, and served in the form of pâté de foie gras, a paste made from the enlarged livers of force-fed Geese.
 
Unexpected exposure
Goose down is widely used for stuffing pillows, duvets and jackets.
 
Allergens
No allergens have yet been characterised.

Potential Cross-Reactivity

Cross-reactivity between Goose and other phylogenetically related bird species may be expected, and in Chicken-allergic patients, significant IgE titers to Parrot, Budgerigar, Chicken, Pigeon, Goose and Duck have been reported (1, 2).

Clinical Experience

IgE mediated reactions
Asthma, allergic rhinitis and allergic conjunctivitis may result following exposure to Duck feathers, epithelial cells or droppings. The allergic manifestations may present as Extrinsic Allergic Alveolitis (3).
 
Of 269 adult patients with suspected skin and respiratory allergies tested for feathers with skin specific IgE tests, 9% of the whole group and 14% of those positive to inhalant allergens were positive to any feather allergen. Two reacted to duck feathers, 12 to goose and 15 to chicken feathers. Symptoms were reported by 58% of feather skin specific IgE positive patients and 55% by other skin specific IgE positive patients. Positive RAST specific IgE tests were surprisingly few which may be explained by possible contamination of the skin extracts by mite allergens (12).
 
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 allergenic proteins may be found in bird serum, droppings, and feathers. Contact may result from handling birds, cleaning their cages, or exposure to the organic dust drifting from where the birds reside.
 
Exposure to avian antigens results in the development of immunoglobulins including IgE (4), IgM (5), IgA and various IgG subclasses (6-8). The development of specific IgG and IgA antibodies to avian proteins does not necessarily indicate disease (9).
 
Diagnosis is based on a characteristic clinical picture and a typical x-ray pattern, accompanied by the presence of specific IgG antibodies (10).
 
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 (11).
 
Clinical allergy to commercial feather products is less common than usually thought, as a result of the removal of rough dry dust, washing and drying at 125OC. The allergens derived from unrefined feathers include bird serum proteins, bird droppings, and feather mites (12).
 
Other reactions
Polyester-filled pillows contain significantly more total weight of Der p 1 mite allergen (Dermatophagoides pteronyssinus) than feather-filled pillows (13).
 
Compiled by Dr Harris Steinman, harris@zingsolutions.com
 

References

  1. de Maat-Bleeker F, van Dijk AG, Berrens L. Allergy to egg yolk possibly induced by sensitization to bird serum antigens. Ann Allergy 1985;54(3):245-8.
  2. van Toorenenbergen AW, Huijskes-Heins MI, Gerth van Wijk R. Different pattern of IgE binding to chicken egg yolk between patients with inhalant allergy to birds and food-allergic children. Int Arch Allergy Immunol 1994;104(2):199-203.
  3. Plessner MM. Une maladie des trieurs de plumes: la fieve de canard. Arch Mal Prof 1960;21:67
  4. Tauer-Reich I, Fruhmann G, Czuppon AB, Baur X. Allergens causing bird fancier’s asthma. Allergy 1994;49(6):448-53
  5. Martinez-Cordero E, Aquilar Leon DE, Retana VN. IgM antiavian antibodies in sera from patients with pigeon breeder’s disease. J Clin Lab Anal 2000;14(5):201-7
  6. Yoshizawa Y, Miyashita Y, Inoue T, Sumi Y, Miyazaki Y, Sato T, et al. Sequential evaluation of clinical and immunological findings in hypersensitivity pneumonitis: serial subclass distribution of antibodies. Clin immunol Immunopathol 1994;73(3):330-7
  7. Todd A, Coan R, Allen A. Pigeon breeder’s lung; IgG subclasses to pigeon Intestinal mucin and IgA antigens. Clin Exp Immunol 1993;92(3):494-9
  8. Baldwin CI, Todd A, Bourke SJ, Allen A, Calvert JE. IgG subclass responses to pigeon intestinal mucin are related to development of pigeon fancier’s lung. Clin Exp Allergy 1998;28(3):349-57
  9. Andersen P, Schonheyder H. Antibodies to hen and duck antigens in poultry workers. Clin Allergy 1984;14(5):421-8
  10. Rodriguez de Castro F, Carrillo T, Castillo R, Blanco C, Diaz F, Cuevas M. Relationship between characteristics of exposure to pigeon antigens. Clinical manifestations and humoral immune response. Chest 1993;103(4):1059-63
  11. Lopata A, Schinkel M, Andersson C, Johansson G, van Hage-Hamsten M. Quantification of IgG antibodies to bird antigens in the diagnosis of extrinsic allergic alveolitis (EAA) using the UniCAP system. (Manuscript in preparation)
  12. Kilpiö K, Mäkinen-Kiljunen S, Haahtela T, Hannuksela M. Allergy to feathers. Allergy 1998;53(2):159-164
  13. Kemp TJ, Siebers RW, Fishwick D, O'Grady GB, Fitzharris P, Crane J. House dust mite allergen in pillows. BMJ 1996;313:916

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.