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The man who nearly killed his quilt: How was this medical mystery solved?

Iki Two months after the onset of symptoms, I couldn't walk without stopping for more than a few minutes without feeling outside, 43 said 43-year-old Scotland, Aberdeenshire, Martin. A case study published in BMJ magazine on Monday.

"It's been 30 minutes to go to bed I can only manage two stairs at a time and I need to sit down and rest. "Taylor added.

The four doctor's appointments did not find a "very sad" reason for Taylor, who never smoked. When he was inadequate, he stayed home from work and He spent most of his days and nights sleeping.

Taylor, at that time, did not know that she suffered from hypersensitivity pneumonia. an inflammation of the lungs as a result of an allergic reaction. Caught early, the disease can be easily cured. It can cause undiagnosed, permanent lung scars and even death.

Unfortunately, in the Taylor case, the doctors he first saw had no idea why.

Sherlock Time

Initially, Taylor was treated for upper respiratory tract infection. However, his health continued to decline over the next three months. A radiologist then rejected a normal chest X-ray of his lungs.

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Worriedly, the family physician called the emergency breathing clinic and was a consultant chest doctor at BMI Albyn Hospital in Aberdeen, Scotland, a 30-minute drive from Aberdeenshire. Owen spoke to John Dempsey.

"The general practitioner was very clever about not accepting the face x-ray result as a face value," Dempsey said. . "

"I think the radiologist thinks it's just a slightly under-exposed chest x-ray." Said.

Dempsey picked up the phone and called Taylor.

"He was coming out of breath, he just walked from one room in his house to another." Said. "Very abnormal for such a young man. It was clear that the patient left progressive and indeed very breathless, and now interfered with the activities of daily life."

Dempsey said the diagnosis was "a bit like a saw". One of the first clues was Taylor's blood study showing that the immune system was exposed to bird protein. However, Taylor told Dempsey that he had no birds, only a cat and a dog.

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"I have a special interest in this disease group," Dempsey said. "And we know that if you have a meticulous background, you can often identify people who trigger lung diseases in the environment."

Dempsey dove deeper: Taylor lived with his wife in a warm, dry house. There was a loft that I didn't visit much, but it had an en-suite bathroom with a shower and a mold on the window. He hadn't traveled to a foreign area. No history of drugs. He worked in an office without a clear exposure. And he played guitar and saxophone in a local band.

"We're getting paid to be curious," Dempsey said. “The danger is that you don't ask enough and assume that diseases are“ idiopathic ”or unexplained. So we miss number one and our patients are subjected to unnecessary tests or treatments. ”

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Eventually, Dempsey's questions hit the rent: The couple recently replaced their synthetic bedding with feather duvets and feather pillows. Taylor had a Quilt Lung disease.

As Sherlock said, "Primary, dear Watson."

Feather Quilt Lung disease

Bird allergies are not uncommon. Symptoms, often referred to as bird enthusiasts' asthma, can range from wheezing cough, runny nose and eye irritation to more severe complications such as asthma and Taylor. People with allergies are most at risk during the year when birds' cages or lofts are cleaned and the birds shed and shed.

Feather Quilt Lung disease is a subset of bird enthusiasts' asthma and is difficult to diagnose because of its timing and variety of symptoms and its rarity.

The onset of symptoms after exposure to new feather duvets or pillows may vary from three weeks to five years. Respiratory difficulty may grow over time and the patient may have night sweats, dry cough, weight loss and fever. If a person reports that there are no birds at home, and most doctors do not intend to ask for bed, this is often misdiagnosed.

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Ime In my experience, most doctors don't ask for this level of detail, Dem Dempsey said, doctors should always ask about home exposure, including beds, molds, house temperature and dryness, and unusual hobbies. pastimes.

Dempsey stressed that early recognition of birds' antigen exposure and removal of beds or other irritants is critical to recovery for patients.

Successful treatment

Although studies have not always supported steroid use, they have been successful in this case, especially because Taylor has also removed hairy beds.

St The steroids given after the diagnosis had a transformative effect within two days, Taylor Taylor said. "As a result, the course of steroids continued for 12 months and the dose gradually decreased over time. Fortunately I was able to stop them completely.

Im I haven't been dizzy since recovery. It doesn't affect me now and my life has been the same. ”

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