A U.K. man had been feeling breathless for months, with spells of dizziness so bad that he had to take weeks off work.
It turned out the culprits were his new feather duvet and pillows.
A new case study, published in the journal BMJ Case Reports, described the case of a 43-year-old man who visited his general practitioner in 2016, complaining of malaise, fatigue and breathlessness.
He was initially diagnosed with a respiratory tract infection, but his symptoms didn’t go away.
“Two months after the onset of the symptoms, I was unable to stand or walk for more than a few minutes at a time without feeling like I was going to pass out,” said the patient, whose identity is kept anonymous in the case report.
Eventually, a specialist asked him about his home. The man said he lived in a warm, dry house with minimal mould, and didn’t have a job or hobbies that would expose him to things that might irritate his lungs. He hadn’t picked up any interesting bugs from travel abroad either, he said.
He had, however, recently replaced his synthetic bedding with a feather duvet and pillows.
Testing showed that the patient had impaired lung function and a high number of antibodies to bird allergens in his blood.
The doctors diagnosed the man with “feather duvet lung.”
Feather duvet lung is a form of hypersensitivity pneumonitis, essentially a reaction to something in the air — in this case, duck or goose feathers found in feather bedding, said Dr. Kerri Johannson, a clinical assistant professor of medicine and director of clinical research in interstitial lung disease at the University of Calgary.
The symptoms are similar to other lung conditions, she said, which means things like coughing and breathlessness. “They’re really non-specific.”
Hypersensitivity pneumonitis, or HP, can include other triggers, like pet birds (commonly called “bird fancier’s lung”), hot tubs (“hot tub lung”), moulds, and in some cases, even wind instruments — “bagpipe lung.”
Researchers aren’t really sure why some people are sensitized to things like feather duvets and some aren’t, she said, though they suspect there might be a genetic component.
“There’s obviously something about the individual and their immune system or their genetics or likely a combination of the two that predisposes them to it,” she said.
Some people, like this man in the U.K., get better when the trigger is removed, she said. In this case, when the man threw out his feather bedding, he started to improve, though doctors also treated him with steroids to improve his lung function.
“It doesn’t affect me at all now and my life is pretty much as it was before,” he wrote.
Patients like him should just avoid the trigger from then on, and stay away from feather pillows, Johannson said.
But not everyone is so lucky.
Some people develop a chronic form of the disease, and develop serious or permanent problems before anyone knows what’s going on. “We don’t have effective therapies yet to undo scarring in the lungs,” she said.
“What we have at this point are medications that try to suppress the inflammation. And they also suppress the immune system,” she said.
“But sometimes despite that, people’s lung disease will continue to progress to advanced scarring and ultimately people can die of their lung condition.”
Some people can stabilize with medication, she said, but they never regain their lost lung function if they have scarring. And some people continue to get worse.
It’s hard to know how common HP is, she said, because it’s likely to be misdiagnosed as other conditions like asthma. And while most of the time, breathing problems won’t actually be HP, she thinks people should be aware of changes in their breathing.
“A change in your functional level or your exercise tolerance is a red flag to get checked,” she said.
It’s also helpful to be aware of any changes in your environment, and whether your breathing problems started before or after those changes. It would also be helpful to know if your problems are only when you’re at home and disappear when you’re on vacation or away, she said.
You might also want to reduce potential triggers, she said, especially if you have a family history of HP. If you do have relatives with HP, she recommends avoiding smoking and vaping, keeping hot tubs well maintained, cleaning musical instruments regularly with alcohol, and avoiding feathers and pet birds.