Takamizawa A, Amari T, Kubo K
Department of Respiratory Medicine, Shinonoi General Hospital, 666-1 Ai Shinonoi, Nagano 388-8004, Japan.
Nihon Kokyuki Gakkai Zasshi. 2000 Dec;38(12):947-51.
A 17-year-old high school student, while carrying out soldering one morning, inhaled 100% acetylene, and experienced nausea and bilateral lower limb numbness several hours later. In the evening his symptoms worsened, dyspnea followed, and the patient was referred to our hospital the next day. On admission chest radiography and CT scanning revealed peripheral ground-glass opacity, patchy infiltrate and Kerley's B line in the right lung fields, and bilateral pleural effusion. Since the laboratory findings revealed leukocytosis without eosinophilia, increased CRP, and hypoxemia, bronchoalveolar lavage (BAL) and transbronchial biopsy (TBLB) was subsequently performed. Fluid analysis revealed marked increases in the total cell and eosinophil counts, and the biopsy result showed eosinophilic and lymphocytic infiltration of the alveolar septa. As a result, the case was diagnosed as acute eosinophilic pneumonia (AEP). Although inhalation of acetylene is known to induce pulmonary edema, all the typical findings of AEP but pulmonary edema were seen. This case demonstrates that AEP may be induced by inhalation of acetylene.
一名17岁的高中生,在一天上午进行焊接时吸入了100%的乙炔,数小时后出现恶心和双下肢麻木。当晚他的症状加重,随后出现呼吸困难,第二天患者被转诊至我院。入院时胸部X线和CT扫描显示右肺野有外周磨玻璃影、斑片状浸润及Kerley B线,双侧胸腔积液。由于实验室检查发现白细胞增多但无嗜酸性粒细胞增多、CRP升高及低氧血症,随后进行了支气管肺泡灌洗(BAL)和经支气管活检(TBLB)。液体分析显示总细胞数和嗜酸性粒细胞计数显著增加,活检结果显示肺泡间隔有嗜酸性和淋巴细胞浸润。结果,该病例被诊断为急性嗜酸性粒细胞性肺炎(AEP)。虽然已知吸入乙炔可诱发肺水肿,但除肺水肿外,AEP的所有典型表现均可见。该病例表明吸入乙炔可能诱发AEP。