Pigeon droppings

Further Reading

Pigeon feathers e215

  • Allergen search puff

    SEARCH FOR ALLERGENS

    Search ImmunoCAP allergens and allergen components. Note that all information is in English.

Code: e7
Latin name: Columba livia
Source material: Droppings
Family: Columbidae
Common names: Pigeon, Feral Pigeon, Town Pigeon, City Pigeon
Direct or indirect contact with Pigeon allergens frequently causes sensitisation.
 
Pigeon allergens may be major components in house dust. Pigeon breeder's disease (PBD) has been found in 6-21% of breeders, the figure differing from country to country.

Allergen Exposure

Geographical distribution
The number of domestic birds is currently estimated at 25 million in the USA and more than 8 million in German households. In Germany, an additional 11 million Pigeons are kept by more than 140 000 registered breeders of fancy Pigeons. (The Homing/Racing Pigeon is a specifically bred variety of Pigeon. These Pigeons are capable of returning home within the day after being released several hundred miles from their loft.) This number does not include the breeding of fattened Pigeons for the table.
 
There are over 300 species of Pigeons and Doves around the world. Feral, Town or City Pigeons are believed to have descended from domesticated strains of the Rock Dove. In the wild they then interbred (and continue to interbreed) with racing Pigeons and Pigeons from bird fanciers' lofts. The Feral Pigeon is found worldwide. It is closely associated with humans and is a common sight in urban environments.
Feral Pigeons are seen as a pest, due to the noise they create from cooing and scratching; damage to cars, domestic premises, monuments and commercial properties due to droppings, the resultant smell, and of course the potential slip hazard. (Gutters and drainpipes may become blocked, leading to flooding and associated problems.) Extensive damage to air conditioning units and other rooftop machinery is commonplace.
 
Environment
Feral Pigeons build their nests in or on buildings and other structures, where they are usually found on ledges or in hollows - often under eaves or on girders. They may, however, be found in more rural situations, e.g., farmland, parks, golf courses, moorland and woodland.
 
Allergens
Pigeon droppings contain excreted serum protein antigens which may have been degraded, making identification difficult. But it is clear that IgA and intestinal mucin are major antigen components. Droppings may also include bacterial endotoxin and other non-specific biological substances.
 
In one study of patients with Pigeon Breeder's Lung, a 21-kDa protein was shown, by immunoblotting tests,  to be the only protein that identifiedindividuals exposed to Pigeons (1). Antigens identified by indirect immunofluorescence staining, and specific for sera from patients with Pigeon Breeders' Lung or healthy Pigeon breeders, have been isolated from Pigeon intestinal mucus. Two antigenic peaks, one being Pigeon intestinal mucin and the other IgA, were isolated. These studies demonstrate that antibodies to two quite different antigens are associated specifically with sera from Pigeon breeders (2). Pigeon intestinal mucin is a complex high-molecular-weight glycoprotein shown to be a key antigen in the development of Pigeon Breeder's Lung. Different IgG subclasses appear to recognise different epitopes on mucin (3).

Potential Cross-Reactivity

Positive IgE antibody reactions to sera and feathers from five bird species (Pigeon, Budgerigar, Parrot, Canary and Hen), and to Pigeon droppings, have been found in subjects with Bird Fancier's Asthma (4). Since antibodies of each of the patients also recognised antigens of birds with which they were not in contact, immunological cross-reactivity between different avian species was suggested.
 
Pigeon allergens also appear to cross-react with Dove droppings (5).

Clinical Experience

IgE-mediated reactions
Diseases associated with exposure to Pigeon include Extrinsic Allergic Alveolitis/hypersensitivity pneumonitis, asthma, allergic rhinitis, ornithosis (microbial infections transmitted to man) and lung inflammation caused by irritant dusts (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 is also known as Pigeon Breeder's Disease, a type of hypersensitivity lung disease due to the inhalation of Pigeon-derived antigens, such as antigens from dried Pigeon droppings (6-8). In Mexico, the most frequent form is due to the inhalation of avian antigens, mainly Pigeon proteins (9). A nasal form of Pigeon Breeder's Disease also exists (10).
 
It occurs after exposure to organic dust and may occur after close contact with Pigeons or other birds such as Budgerigars, Parrots, Canaries, Parakeets, Cockatiels, and Doves. Exposure results in the development of various immunoglobulins including IgE (4), IgM (11), IgA and various IgG subclasses (12-14). Th e antibodies may be found in the sera and saliva of patients (15) as well as in the sera of asymptomatic but exposed subjects (16).
 
The allergenic proteins are found in bird serum, droppings, skin scales, feathers and Pigeon bloom (a waxy fine dust which coats the feathers of Pigeons). "Fancy" birds produce copious bloom; poultry (Duck, Chicken, Turkey) produces very little bloom. Contact may result from handling birds, cleaning the loft, or from exposure to the organic dust drifting down from a ceiling where birds nest.
 
Diagnosis is based on a characteristic clinical picture and a typical x-ray pattern, accompanied by the presence of specific IgG antibodies (17).
 
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 caused by bird antigens (18).
 
Extrinsic Allergic Alveolitis may also occur in families, as reported in a study where the cause was wild city Pigeons (19).
 
Extrinsic Allergic Alveolitis is not common in childhood (20-22). A study from Malta reports on 5 cases in the pediatric population. All were males, and were initially diagnosed as having other respiratory illnesses or mental disturbances. A final correct diagnosis was made based on a history of exposure to birds, clinical findings, positive avian precipitins, a restrictive defect shown on pulmonary function tests, and a suggestive chest X-ray appearance (23).
 
A typical clinical presentation would be a male Pigeon breeder who develops a sudden fever, cough and dyspnea, with diffuse nodular shadows on the chest X-ray film (24). In a study conducted in the Canary Islands, of 343 Pigeon breeders, 29 (8%) fulfilled the classic Pigeon Breeder's Disease criteria. One hundred and six (31%) had rhinitis, 62 (19%) had immediate bronchial symptoms, and 51 (15%) suffered from chronic bronchitis. A significant level of specific IgG was detected in 139 (40%) cases. A statistical relationship between the intensity of exposure and specific IgG response was also found (17).
 
The presence of IgG, IgA, IgM and IgE antibodies against Pigeon serum and Pigeon droppings has been demonstrated in serum from symptomatic breeders (6) (25) (26) (27). Positive IgE antibody reactions to sera and feathers from five bird species (Pigeon, Budgerigar, Parrot, Canary and Hen), and to Pigeon droppings, have been found in subjects with Bird Fancier's Asthma (4). Pigeon Breeder's Disease has been found in 6-21% of breeders (6), with the figure differing from country to country. Rhinitis in bird fanciers can be associated with an IgE-mediated allergy to bird antigens.
 
A 61-year-old woman was diagnosed with chronic hypersensitivity pneumonitis due to Wild Pigeons. The patient was not a Pigeon breeder, but she could have been exposed to Pigeons at her workplace. She had specific antibodies against Pigeon serum and droppings, and her peripheral lymphocytes showed proliferation in response to Pigeon serum. A positive provocation test involving inhalation of Pigeon serum confirmed that she had chronic hypersensitivity pneumonitis caused by allergy to Pigeons. This is a rare case of chronic hypersensitivity pneumonitis, associated with Wild Pigeons, that progressed to pulmonary fibrosis (28).
 
Other reactions
Acute urticaria may be caused by Pigeon Ticks, which, according to a report, had dropped from wooden ceiling beams. The patient was living in the centre of Milan in a very old house, where numerous Pigeons had built their nests under the rooftop (29).
 
The House Dust Mite Dermatophagoides farinae has been found in samples from a Pigeon loft. Besides Mites of the family Pyroglyphidae, Mites of the Tyroglyphidae family and/or mucedine were found. House Dust Mites should be considered in patients with apparent allergic disease to Pigeon (30).
 
Compiled by Dr Harris Steinman, harris@zingsolutions.com

References

  1. Hisauchi-Kojima K, Sumi Y, Miyashita Y, Miyake S, Toyoda H, Kurup VP, Yoshizawa Y. Purification of the antigenic components of pigeon dropping extract, the responsible agent for cellular immunity in pigeon breeder's disease. J Allergy Clin Immunol 1999;103(6):1158-65
  2. Todd A, Coan RM, Allen A. Pigeon breeders' lung: pigeon intestinal mucin, an antigen distinct from pigeon IgA. Clin Exp Immunol 1991;85(3):453-8
  3. Baldwin CI, Todd A, Bourke SJ, Allen A, Calvert JE. Pigeon fanciers' lung: identification of disease-associated carbohydrate epitopes on pigeon intestinal mucin. Clin Exp Immunol 1999;117(2):230-6
  4. Tauer-Reich I, Fruhmann G, Czuppon AB, Baur X. Allergens causing bird fancier’s asthma. Allergy 1994;49:448-53.
  5. McClellan JS, Albers GM, Noyes BE, Sotelo C, Petterchak JA, Knutsen AP. B-lymphocyte aggregates in alveoli from a child with hypersensitivity pneumonitis (bird breeders lung). Ann Allergy Asthma Immunol 1999;83(5):357-60
  6. Pelikan Z, Schlot JDL, Koedijk FHJ. The late bronchus-obstructive response to bronchial challenge with pigeon faeces and its correlation with precipitating antibodies (IgG) in the serum of patients having long-term contact with pigeons. Clin Allergy 1983;13:203-11
  7. Fink JN. Hypersensitivity pneumonitis. J Allergy Clin Immunol 1973;52:309-17.
  8. Liang SL. Exogenous allergic alveolitis--a clinico-radiologic analysis of 15 cases of pigeon breeder's lung. [Chinese] Zhonghua Fang She Xue Za Zhi 1989;23(3):146-8
  9. Chapela-Mendoza R, Selman-Lama M. Extrinsic allergic alveolitis. Clinical experience at the Instituto National de Enfermedades Respiratorias (INER). [Spanish] Gac Med Mex 1999;135(6):577-87
  10. Pelikan Z, Pelikan-Filipek M. A new disease: a nasal form of pigeon breeder’s disease. Allergy 1983;38:309-18.
  11. 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
  12. 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
  13. 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
  14. 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
  15. McSharry C, Macleod K, McGregor S, Speekenbrink AB, Sriram S, Boyd F, et al. Mucosal immunity in extrinsic allergic alveolitis: salivary immunoglobulins and antibody against inhaled avian antigens among pigeon breeders. Clin Exp Allergy 1999;29(7):957-64
  16. Rodrigo MJ, Benavent MI, Cruz MJ, Rosell M, Murio C, Pascual C, et al. Detection of specific antibodies to pigeon serum and bloom antigens by enzyme linked immunosorbent assay in pigeon breeder’s disease. Occup Environ Med 2000;57(3):159-64
  17. 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
  18. 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)
  19. du Marchie Sarvaas GJ, Merkus PJ, de Jongste JC. A family with extrinsic allergic alveolitis caused by wild city pigeons: A case report. Pediatrics 2000;105(5):E62
  20. Hilhorst MI, van Ewijk E, Veenhoven RH, Roorda RJ. Asthmatic child without asthma. [Dutch] Ned Tijdschr Geneeskd 1999;143(49):2449-52
  21. Tsai E, Couture D, Hughes DM. A pediatric case of pigeon breeder's disease in Nova Scotia. Can Respir J 1998;5(6):507-10
  22. Severien C, Artlich A, Jonas S. Pigeon breeder's disease in childhood. [German] Klin Padiatr 1998;210(6):413-7
  23. Grech V, Vella C, Lenicker H. Pigeon breeder's lung in childhood: varied clinical picture at presentation. Pediatr Pulmonol 2000;30(2):145-8
  24. Mouri T, Obara A, Konishi K, Tamura M, Tomichi N, Ishii M, Kudou K. A case of pigeon breeder's lung. [Japanese] Nihon Kyobu Shikkan Gakkai Zasshi 1990;28(1):165-71
  25. Patterson R, Schatz M, Fink JN, DeSwarte RS, Roberts M, Cugell D. Pigeon Breeder’s disease. I. Serum immunoglobulin concentrations; IgG, IgM, IgA and IgE antibodies against pigeon serum. Am J Med 1976;60:144-51.
  26. Ebner H, Kraft D, Goetz M, Rumpold H, Muhar F, Schroder H, Yman L. Inhalationsallergien durch Vogelantigene: Nachweis von IgE-Antikörpern gegen Taubenserum- und Taubenkot-Komponenten mittels RAST. Berichtsband 1981:161- 65
  27. Fairshter RD, Martinez IP, Novey HS. Chronic airflow obstruction in a patient with pigeon breeder’s lung; Prevalence of IgE antibodies to avian antigens. Respiration 1982;43:142-9
  28. Muramatsu T, Miyazaki E, Sawabe T, Shigenaga T, Matsumoto T, Sugisaki K, Kumamoto T, Tsuda T. A case of chronic hypersensitivity pneumonitis due to wild pigeons. [Japanese] Nihon Kokyuki Gakkai Zasshi 2001;39(3):220-5
  29. Veraldi S, Scarabelli G, Grimalt R. Acute urticaria caused by pigeon ticks (Argas reflexus). Int J Dermatol 1996;35(1):34-5
  30. Enge A, Hiepe T, Ribbeck R. Occurrence of housedust mites (Astigmata; Pyroglyphidae) in stables. [German] Angew Parasitol 1984;25(3):132-41

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