Sasaki S, Kawanami R, Motizuki Y, Nakahara Y, Kawamura T, Tanaka A, Watanabe S
Department of Internal Medicine, National Himeji Hospital, Hyogo, Japan.
Nihon Kokyuki Gakkai Zasshi. 2000 Jul;38(7):540-4.
An 84-year-old man was referred to our hospital because of fever, cough, and hemoptysis. The patient had acute respiratory failure (PaO2 < 40 mmHg) on admission, with diffuse interstitial infiltration and bilateral pleural effusion. The bronchoalveolar lavage fluid was bloody, and contained a high percentage of eosinophils (32%). A diagnosis of acute eosinophilic pneumonia was established, and the patient made a rapid recovery after corticosteroids were administered. When the DLST (drug lymphocyte stimulation test) was performed after the corticosteroid therapy was stopped, it was positive for serrapeptase, which had been prescribed for chronic cystitis for 3 months before the onset of the pneumonia. This was a case of drug (serrapeptase)-induced pneumonitis manifesting as acute eosinophilic pneumonia.
一名84岁男性因发热、咳嗽和咯血被转诊至我院。患者入院时出现急性呼吸衰竭（动脉血氧分压<40 mmHg），伴有弥漫性间质浸润和双侧胸腔积液。支气管肺泡灌洗液呈血性，嗜酸性粒细胞比例较高（32%）。确诊为急性嗜酸性粒细胞性肺炎，患者在使用糖皮质激素后迅速康复。在停用糖皮质激素治疗后进行药物淋巴细胞刺激试验（DLST）时，结果显示对 serrapeptase 呈阳性，serrapeptase 在肺炎发病前3个月曾用于治疗慢性膀胱炎。这是一例药物（serrapeptase）诱发的肺炎，表现为急性嗜酸性粒细胞性肺炎。
