As winter approaches, it may seem tempting to curl up under a thick down duvet, but experts warn that this can lead not only to warm toes.
Doctors reported a case of “light duvets” – pneumonia caused by inhalation of dust from feathers in bedding – and urged medical personnel to be alert if patients had unexplained shortness of breath.
The team says the condition, a form of hypersensitive pneumonitis, boils down to an immune response. Symptoms include night sweats, dry cough and shortness of breath – repeated exposure to the cause can cause irreversible scarring of the lungs.
"Health professionals are usually taught to ask patients with respiratory symptoms if they have pets, such as birds, but, according to the authors, the storytelling usually does not cover the question of the effect of feathers on blankets and pillows," they write. , "This is an important omission, as the use of feathers rather than synthetic bedding is common."
Dr. Owen Dempsey, a nursing consultant at the Royal Hospital of Aberdeen and co-author of the report, said that people should not be in a hurry to throw away blankets and pillows, but note that if they have breathing problems when switching to feather bedding.
He added that, although hypersensitive pneumonitis appears to be rare, and the report highlights only one case of a light duvet, many cases go unnoticed. “I suspect this is the tip of the iceberg,” he said. “I think there are many revelations that we don’t know about, and simply because we don’t know about them, they are ignored.”
In a BMJ Case Reports report, Dempsey and his colleagues from Victoria Hospital in Kirkcaldy and Aberdeen's Royal Infirmary describe how a 43-year-old man who did not smoke turned to his doctor after three months of shortness of breath, fatigue, and poor health.
His symptoms were reduced to lower respiratory tract infections, but worsened after a brief improvement.
“Two months after the onset of symptoms, I could neither stand nor walk for more than a few minutes at a time, without feeling like I was swooning,” said a patient who was not named in the report. "Going upstairs to bed was a 30-minute lesson, since I could only control two steps at a time, and then I needed to sit and rest."
The man’s blood test was normal and he had a chest x-ray. Although this was reported as normal, he had severe shortness of breath, and a general practitioner referred him to a respiratory clinic. Concerned about the X-ray, Dempsey delved into the personal situation of the man and found out that he had recently switched from synthetic to duvet.
The man was advised to quit bedding, check the chimney and attic for birds and make sure that any mold in the house was processed.
Subsequent tests showed that humans had unusually high antibodies to certain bird proteins – including pigeons and parrots. In addition, further scans showed a pattern in the lungs that hinted at hypersensitive pneumonitis, while its lung function was significantly impaired.
Within a month after he lost the bedding from feathers, the man showed obvious improvements and after a subsequent course of steroids felt completely fine after six months.
The team said that the most likely diagnosis was a duvet of the lung. They say this is a rare subgroup of the “easy bird lover,” which in itself is a form of hypersensitive pneumonitis caused by exposure to feathers and droppings. Other forms of hypersensitive pneumonitis include “farmer’s lung”, “bagpiper’s lung”, “paprika’s chunk lung” and even “mummy’s lung”, which reflects a wide range of actions associated with inhaling substances that can cause serious pneumonia. ,
“There are several hundred different types of hypersensitive pneumonitis,” Dempsey said. “It’s very important for medical professionals to be curious, keep a thorough history and ask people about the impact, because there are many things that people do that we don’t always appreciate when we are in a clinic or surgery.”