Arets H G, Breukels M A, Oosterkamp R F, van der Ent C K, Sanders E A
Afd. Longziekten, Wilhelmina Kinderziekenhuis, Utrecht.
Ned Tijdschr Geneeskd. 1999 Apr 10;143(15):769-72.
Three children, two boys aged 16 and 11 years and a girl aged 16 years, with symptoms resembling asthma had been treated for years with inhaled corticosteroids and beta 2-sympathicomimetics without satisfactory results. It was found that the antibody production after vaccination with 23-valent pneumococcal vaccine was impaired. The symptoms diminished during maintenance treatment with antibiotics in two children and with intravenous immunoglobulins in one. In patients with recurrent respiratory problems, but no specific history of asthma, immunological investigation is warranted, especially in patients whose 'asthma' is accompanied by respiratory infections. When treated for their immunodeficiency these patients show remarkable improvement and the need for steroids often disappears.
三名儿童,两名男孩分别为16岁和11岁,一名女孩为16岁,有类似哮喘的症状,多年来一直使用吸入性糖皮质激素和β2-拟交感神经药治疗,但效果不佳。发现接种23价肺炎球菌疫苗后抗体产生受损。两名儿童在使用抗生素维持治疗期间症状减轻,一名儿童在使用静脉注射免疫球蛋白期间症状减轻。对于有反复呼吸道问题但无哮喘特异性病史的患者,尤其是“哮喘”伴有呼吸道感染的患者,有必要进行免疫学检查。当针对其免疫缺陷进行治疗时,这些患者会有显著改善,对类固醇的需求往往也会消失。