Leaker B, Cambridge G, du Bois R M, Neild G H
Department of Nephrology, University College and Middlesex School of Medicine, Middlesex Hospital, London.
Thorax. 1992 Nov;47(11):988-90. doi: 10.1136/thx.47.11.988.
Idiopathic pulmonary haemosiderosis remains a diagnosis of exclusion in patients who present with pulmonary alveolar haemorrhage. Systemic vasculitis developed in a patient with an eight year history of idiopathic pulmonary haemosiderosis. The diagnosis was confirmed by a rising titre of antineutrophil cytoplasmic antibodies directed against myeloperoxidase. Treatment with immunosuppressive agents resulted in complete resolution of symptoms and suppression of the antibodies. Measurement of antineutrophil cytoplasmic antibodies is recommended for all patients with pulmonary alveolar haemorrhage syndromes.
特发性肺含铁血黄素沉着症仍然是肺泡出血患者排除性诊断。一名有八年特发性肺含铁血黄素沉着症病史的患者发生了系统性血管炎。抗髓过氧化物酶的抗中性粒细胞胞浆抗体滴度升高证实了该诊断。免疫抑制剂治疗使症状完全缓解并抑制了抗体。对于所有肺泡出血综合征患者,建议检测抗中性粒细胞胞浆抗体。