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[一例创伤后双侧嗜酸性粒细胞性胸腔积液病例]

[A case of post-traumatic bilateral eosinophilic pleural effusion].

作者信息

Yoshimoto Akihiro, Fujimura Masaki, Nakamura Hiroyuki, Nakao Shinji

机构信息

Department of Internal Medicine, Toyama City Hospital, Imaizumihokubucho 2-1, Toyama, 939-8511, Japan.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2002 Dec;40(12):950-4.

Abstract

A 58-year-old man was admitted to our hospital with chest pain caused by chest trauma. After admission, his chest pain decreased and he was discharged. Later, he was admitted again with a high fever and dyspnea. Laboratory findings on second admission showed a leukocyte count of 7,900/microliter (9% eosinophils) and a C-reactive protein of 17.0 mg/dl. Chest radiography and chest CT scanning on second admission showed moderate bilateral pleural effusion. Close examination showed an increase of eosinophils in the pleural effusion (14% of total cell counts on the right and 27% of total cell counts on the left) that was exudate. Post-traumatic bilateral eosinophilic pleural effusion was diagnosed. The patient was treated with antibiotic therapy and his condition improved. A chest CT scan afterwards showed improvement of the bilateral pleural effusion. The eosinophil count in the peripheral blood was 1% at chest trauma, 15% in the hospital to the max and decreased to 3% with the decrease of pleural effusion. Post-traumatic eosinophilic pleural effusion may be accompanied with inflammatory findings, and the mechanism is guessed by immunological reaction.

摘要

一名58岁男性因胸部外伤导致胸痛入院。入院后,他的胸痛减轻并出院。后来,他因高热和呼吸困难再次入院。第二次入院时的实验室检查结果显示白细胞计数为7900/微升(嗜酸性粒细胞占9%),C反应蛋白为17.0毫克/分升。第二次入院时的胸部X线和胸部CT扫描显示双侧中等量胸腔积液。仔细检查发现胸腔积液中嗜酸性粒细胞增多(右侧占总细胞计数的14%,左侧占总细胞计数的27%),为渗出液。诊断为创伤后双侧嗜酸性粒细胞性胸腔积液。患者接受了抗生素治疗,病情好转。随后的胸部CT扫描显示双侧胸腔积液有所改善。胸部外伤时外周血嗜酸性粒细胞计数为1%,住院期间最高升至15%,随着胸腔积液减少降至3%。创伤后嗜酸性粒细胞性胸腔积液可能伴有炎症表现,其机制推测为免疫反应。

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