. Allergopedia

Allergy to feathers

Ματέσκου Κάρμεν
Otorhinolaryngologist, Registrar A General Filiates Hospital - Ωτορινολαρυγγολόγος, Επιμελήτρια Α΄Γεν. Νοσοκομείο Φιλιατών, Θεσπρωτίας

Bird fancier's lung (BFL) is a type of hypersensitivity pneumonitis, which is induced by inhalation of bird related antigens. The diagnosis of BFL induced by feathers is difficult because feathers are generally not recognized as a causative antigen of BFL. Feather beds including duvets, pillows, and cushions are now popular all over the world. Physicians should be aware of feathers as a cause of BFL since this induction seems to be more prevalent.

Skin prick test reactivity to commercial and self-made feather-allergen extracts was examined by Kilpiö K et al (1998) in 269 consecutive adult patients with suspected allergic cutaneous or respiratory symptoms who had been referred to a university clinic. Some 177 subjects reacted to any inhalant allergen. Twenty-four (9% of the whole group and 14% of those positive to any inhalant allergen) reacted to commercial feather extracts from ALK (Hørsholm, Denmark), and 51 to any of the seven feather extracts used. Feather-mix RAST (Pharmacia, Sweden) was positive in three cases only. Skin prick test or CAP-RAST or both to house-dust mite were positive in 16 of those 24 subjects positive to the commercial feather extracts, but in only 23 of the 150 other atopic subjects (P < 0.001). A nasal challenge with a feather extract was made in 20 cases, always with negative result. In immunospot studies, concomitant allergy to feather-allergen extracts and house-dust mite could be demonstrated. Mite allergens in feather extracts were verified in RAST-inhibition studies. A clinically significant feather allergy was found in one patient only. The results suggest that true feather allergy is very rare, and most of the positive reactions seen in skin prick tests to feather extracts are probably caused by mite allergens present in feathers[1]. There is high frequency (32%) of the association of sensitization lo egg proteins, particularly egg yolk, in a selected population of patients with known allergy to bird feathers, thus suggesting that in some patients feather sensitization could trigger or somehow facilitate the later sensitization to egg yolk protein [2].

The feather Mix (Chicken, Duck, Goose) [ Latin Name: N/A, NCCLS Code: N/A] is characterized and not standardized due to the heterogeneity of the allergen composition of this mixture. Each component is well characterized and the ratio of the various components in the mix is kept constant for consistency purposes.

The allergen profile of feather is not completely known.  Some studies indicate true feather allergy is very rare.  Many patients react to feather dust, including keratin particles, bird serum, feces, and bird mites and their waste.  Patients allergic to feather may react to protein at molecular weight ranges from 17 to >200 kDa.  Some patients react to common epitopes in feather and egg yolk and chicken serum albumin (alpha-livetin).  Feather Mix may also be contaminated with dust mite particles and endotoxins.

Allergenic Proteins (with molecular weight): 70, 95 and 200 kDa

In-House Clinical Evaluation Results:

Sensitivity: 90% Specificity: 100%

Efficiency: 94%  Number of Samples: 15.


1. Kilpiö K, Mäkinen-Kiljunen S, Haahtela T, Hannuksela M. Allergy to feathers. Allergy. 1998 Feb;53(2):159-64.

2. Añibarro Bausela B, Martín Esteban M, Martínez Alzamora F, Pascual Marcos C, Ojeda Casas JA. Egg protein sensitization in patients with bird feather allergy. Allergy. 1991 Nov;46(8):614-8.

3. Hitachi Chemical  Diagnostics, Inc. Allergy Monograph Series. Resource Duide to the Most Common Allergens. 2000-2003.

4. Inase N, Ohtani Y, Endo J, Miyake S, Yoshizawa Y. Feather duvet lung. Med Sci Monit. 2003 May;9(5):CS37-40.

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