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Taking into account these results, the patient was diagnosed with hypersensitivity pneumonitis. Antigen avoidance, oral glucocorticoids and azathioprine achieved an initial improvement in PFTs and symptoms; however, the patient still deteriorated, requiring long-term oxygen therapy. While working the patient up for lung transplantation, rituximab was given to good effect (acting as a bridging therapy) as it achieved symptomatic relief and stabilisation of her PFTs.<\/jats:p>","DOI":"10.1136\/bcr-2020-237232","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T18:18:21Z","timestamp":1608661101000},"page":"e237232","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Rituximab therapy in a patient with steroid-refractory bird fancier\u2019s lung"],"prefix":"10.1136","volume":"13","author":[{"given":"Etienne","family":"Ceci Bonello","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Mater Dei Hospital, L-Imsida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Gauci","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Mater Dei Hospital, L-Imsida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Bonello","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Mater Dei Hospital, L-Imsida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Fsadni","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Mater Dei Hospital, L-Imsida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Montefort","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Mater Dei Hospital, L-Imsida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,12,22]]},"reference":[{"doi-asserted-by":"publisher","key":"2025082710571536000_13.12.e237232.1","DOI":"10.1016\/j.ccm.2011.12.004"},{"doi-asserted-by":"publisher","key":"2025082710571536000_13.12.e237232.2","DOI":"10.1186\/2045-7022-3-5"},{"doi-asserted-by":"publisher","key":"2025082710571536000_13.12.e237232.3","DOI":"10.1016\/j.ccm.2004.04.001"},{"key":"2025082710571536000_13.12.e237232.4","first-page":"25","article-title":"Emphysematous changes in hypersensitivity pneumonitis: a retrospective analysis of 12 patients","volume":"24","author":"Baqir","year":"2018","journal-title":"Respir Med Case Rep"},{"key":"2025082710571536000_13.12.e237232.5","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1164\/rccm.201608-1675PP","article-title":"Diagnosis and treatment of hypersensitivity pneumonia","volume":"196","author":"Salisbury","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2025082710571536000_13.12.e237232.6","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1164\/rccm.201611-2201PP","article-title":"Hypersensitivity pneumonitis: perspectives in diagnosis and management","volume":"196","author":"Vasakova","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"doi-asserted-by":"publisher","key":"2025082710571536000_13.12.e237232.7","DOI":"10.1016\/j.chest.2016.10.029"},{"doi-asserted-by":"publisher","key":"2025082710571536000_13.12.e237232.8","DOI":"10.1136\/thoraxjnl-2013-203265"},{"key":"2025082710571536000_13.12.e237232.9","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.arbres.2019.07.013","article-title":"Addition of rituximab to oral corticosteroids in the treatment of chronic hypersensitivity pneumonitis","volume":"56","author":"Morell","year":"2020","journal-title":"Arch Bronconeumol"},{"doi-asserted-by":"publisher","key":"2025082710571536000_13.12.e237232.10","DOI":"10.4049\/jimmunol.1600089"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-237232","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:57:24Z","timestamp":1756317444000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-237232"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":10,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,22]]},"published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1136\/bcr-2020-237232"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-237232","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,12]]}}}