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[一位祖父及其两岁半孙子患家族性夏季型过敏性肺炎]

[Familial summer-type hypersensitivity pneumonitis in a grandfather and his two-and-a-half-year-old grandson].

作者信息

Ubukata M, Takayanagi N, Matsushima H, Sakamoto T, Motegi M, Yanagisawa T, Sugita Y, Kawabata Y, Kanazawa M

机构信息

Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kounan-machi, Ohsato-gun, Saitama, Japan.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2000 Dec;38(12):923-7.

Abstract

We encountered a family in which two of the six members, the grandfather and his grandson, had summer-type hypersensitivity pneumonitis in late summer. Chest computed tomography of these patients showed small, diffuse nodular shadows in both lung fields, with mosaic-like opacities in the grandfather and ground glass opacity of both lung fields in the grandson. Bronchoalveolar lavage fluid from the grandfather disclosed high total cell counts, high percentages of lymphocytes, and a low ratio of CD 4+ cells to CD 8+ cells. Transbronchial lung biopsy specimens obtained from the same patient revealed alveolitis with non-caseous epithelioid cell granulomas in the interstitium and Masson bodies in the alveolar septa. These two patients recovered spontaneously after hospital admission. They had positive results in provocation tests for their home and were positive for serum anti-Trichosporon cutaneum (T. asahii, T. mucoides) antibodies. Both cases were accordingly diagnosed as summer-type hypersensitivity pneumonitis.

摘要

我们遇到了一个家庭,该家庭的六名成员中有两名,即祖父和他的孙子,在夏末患有夏季型过敏性肺炎。这些患者的胸部计算机断层扫描显示双肺野有小的弥漫性结节状阴影,祖父的肺部有马赛克样混浊,孙子的双肺野有磨玻璃样混浊。祖父的支气管肺泡灌洗液显示总细胞计数高、淋巴细胞百分比高以及CD4 +细胞与CD8 +细胞的比例低。从同一患者获得的经支气管肺活检标本显示间质性肺泡炎伴有非干酪样上皮样细胞肉芽肿以及肺泡间隔中的马松小体。这两名患者入院后自发康复。他们在家中的激发试验结果为阳性,血清抗皮肤毛孢子菌(阿萨希毛孢子菌、黏液毛孢子菌)抗体检测也呈阳性。因此,这两例均被诊断为夏季型过敏性肺炎。

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