Mysterious feather duvet lung disease nearly kills a man

By Angela Betsaida B. Laguipo, BSNNov 19 2019

A soft pillow and a warm duvet are all you need to have a soothing and relaxing sleep, especially during the frigid season. However, a man from the United Kingdom nearly died because of a mysterious illness related to a duvet. It was later found out by doctors that the culprit for his lung disease is his newly-bought feather duvet.

Image Credit: Marahwan / Shutterstock

After changing his bedding, he experienced a strange and rare condition that left him gasping for air. A team of researchers and doctors studied his case, which led them to a diagnosis of “feather-duvet lung.”

Published in the British Medical Journal (BMJ) Case Reports, the case involved a 43-year-old man who had to go through months of fatigue, dizziness, and breathlessness before consulting a physician in November 2016.

Initially, the doctor diagnosed him with a lower respiratory tract infection, specifically bronchitis. After treatment, his conditions did not improve, and after a month, the symptoms worsened. It came to a point when he could no longer walk to the next room in his house without feeling out of breath. His condition forced him to take 14 days off work.

After a series of doctor visits, the man’s mysterious breathing problem remained unidentified. The doctors were left baffled because there were no signs of anything that might have caused the illness. He lived in a warm and dry house, almost entirely free of mold.

Though the man owned a dog and a cat, he had no birds. Exposure to organic dust from bird feathers may result in hypersensitivity pneumonitis, an immune system disorder wherein the lungs become inflamed due to particles inhaled from the environment.

Feather-duvet lung diagnosis

A respiratory specialist, Owen Dempsey from Aberdeen Royal Infirmary, interviewed the patient and unveiled that the man had recently bought a duvet and pillows containing feathers, which had replaced his previous synthetic bedding.

From there, doctors focused on feathers as the source of his hypersensitivity reaction. The most common type of hypersensitivity pneumonitis is known as bird fancier’s lung (BFL), which had a rare subgroup, called feather duvet lung (FDL).

With a diagnosis in mind, the doctors determined the best treatment for the patient’s long-term misery.

“FDL is caused by inhalation of organic dust from duck or goose feathers found in duvets and pillows. Antigen inhalation triggers an immunological cascade, resulting in parenchymal inflammation. Repeated exposure may result in irreversible lung fibrosis,” the team explained in the case report.

The patient’s symptoms, including his chest radiograph and lung function tests, improved after removing the bedding. Aside from this, the doctor gave him oral corticosteroid therapy. His condition rapidly improved within a month, and by six months, he felt well again. After one year, his symptoms completely cleared and has fully recovered.

The case calls that doctors and health care providers take detailed histories of patients to uncover things in the environment that can trigger lung disease. The case emphasized the importance of taking meticulous exposure history, including bedding in patients with unexplained breathlessness. Prompt diagnosis and removal of the antigen may prevent the development of irreversible lung fibrosis or scarring.

What is feather duvet lung?

Feather duvet lung (FDL) is a rare subgroup of bird fancier’s lung (BFL), caused by the inhalation of organic dust due to goose or duck feathers in duvets or pillows. BFL is a type of hypersensitivity pneumonitis induced by inhalation of bird-related antigens. Diagnosing this disease is difficult because feathers are not generally recognized as a causative antigen of BFL.

FDL is also an immunologically mediated form of hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis. The symptoms of FDL are non-specific, including systemic malaise and influenza-like symptoms. In worse cases, it can lead to acute breathlessness that occurs about 4 to 8 hours after feather antigen exposure. Since these symptoms are non-specific, many cases of FDL are missed or diagnosed late.  

IF FDL is left untreated, it can lead to a complication called pulmonary or lung fibrosis, which is a type of lung disease that occurs when the lung tissue becomes damaged and scarred. Since thickened scar tissue is present in the lungs, it makes it hard for the organ to work properly.