Nakano K, Gemma H, Ono T, Ito I, Chida K, Nakamura H
Department of Respiratory Disease, Fukuroi Municipal Hospital, Japan.
Nihon Kokyuki Gakkai Zasshi. 2001 Jan;39(1):24-9.
A 45-year-old man was admitted with a severe dry cough and fever. He had been given 100 mg/day of minocycline and other drugs for 9 days to treat hematopyuria. Chest X-ray film showed multiple nodular shadows with diffuse reticular shadows. After all the drugs were discontinued, the fever and the shadows improved, but the severe dry cough persisted. The day 4 bronchofiberscopic findings included multiple white plaques in the tracheobronchial mucosa. Punch biopsy specimens obtained from the white plaques revealed severe eosinophil infiltration, and the eosinophil count in the bronchoalveolar lavage fluid had increased (differential count 23%). After three days of 125 mg/day of methylprednisolone sodium succinate injection therapy, the severe cough, the X-ray shadows and the white plaques disappeared. With a positive result in the lymphocyte migration inhibition test, the patient's condition was diagnosed as minocycline-induced eosinophilic pneumonia.
一名45岁男性因严重干咳和发热入院。他因治疗血尿接受了每日100毫克米诺环素及其他药物治疗9天。胸部X光片显示多个结节状阴影伴有弥漫性网状阴影。停用所有药物后,发热和阴影有所改善,但严重干咳仍持续。支气管纤维镜检查结果显示,第4天时气管支气管黏膜有多个白色斑块。从白色斑块获取的穿刺活检标本显示有严重的嗜酸性粒细胞浸润,支气管肺泡灌洗液中的嗜酸性粒细胞计数增加(分类计数23%)。在接受每日125毫克琥珀酸甲泼尼龙注射治疗三天后,严重咳嗽、X光阴影和白色斑块消失。淋巴细胞迁移抑制试验结果呈阳性,患者被诊断为米诺环素诱发的嗜酸性粒细胞性肺炎。