Strong D H, Westcott J Y, Biller J A, Morrison J L, Effros R M, Maloney J P
Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
Thorax. 2003 Sep;58(9):823-4. doi: 10.1136/thorax.58.9.823.
Smoking of crystalline cocaine, known as "crack" cocaine, has been associated with eosinophilic pneumonitis, but not with pleural effusions. We describe a patient with eosinophilic pneumonitis with an eosinophilic "empyema" after using "crack" cocaine. The illness resolved with corticosteroids. We hypothesised that his effusion would have increased levels of eosinophil cytokines that promote oedema, and found a marked increase in pleural vascular endothelial growth factor (VEGF) and smaller increases in interleukins IL-5, IL-6, and IL-8. In the setting of "crack" use, we suggest that a pleural effusion that appears grossly to be pus should be evaluated for eosinophilic inflammation. Such eosinophilic effusions may respond to corticosteroids alone, consistent with a non-infectious process driven by proinflammatory cytokines.
吸食被称为“快克”可卡因的结晶性可卡因，已被证实与嗜酸性粒细胞性肺炎有关，但与胸腔积液无关。我们描述了一名在使用“快克”可卡因后发生嗜酸性粒细胞性肺炎并伴有嗜酸性粒细胞“脓胸”的患者。该疾病经皮质类固醇治疗后痊愈。我们推测他的胸腔积液中促进水肿的嗜酸性粒细胞细胞因子水平会升高，并发现胸膜血管内皮生长因子（VEGF）显著增加，白细胞介素IL - 5、IL - 6和IL - 8有较小幅度的增加。在使用“快克”可卡因的情况下，我们建议对于外观上看似脓液的胸腔积液，应评估其是否存在嗜酸性粒细胞炎症。这种嗜酸性胸腔积液可能仅对皮质类固醇有反应，这与由促炎细胞因子驱动的非感染性过程一致。
