Parambil Joseph G, Daniels Craig E, Zehr Kenton J, Utz James P
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Chest. 2005 Nov;128(5):3678-80. doi: 10.1378/chest.128.5.3678.
A 68-year-old white man was evaluated for failure to wean from mechanical ventilation after cardiac surgery. Bronchoscopy performed prior to percutaneous dilatational tracheotomy revealed circumferential strikingly dark-colored airways, most prominent in the trachea and mainstem bronchi, extending distally into all airways with overlying desiccated black secretions. Histologic examination of bronchial mucosal biopsy samples and the desiccated secretions showed acute bronchitis and necrotic debris, respectively. This finding and the patient's history led to testing for plasma homogentisic acid, which was found to be elevated at 12.6 mug/mL, establishing the first diagnosis of alkaptonuria made using flexible bronchoscopy.
一名68岁的白人男性因心脏手术后无法脱离机械通气而接受评估。在经皮扩张气管切开术前进行的支气管镜检查显示，气道呈环形显著深色，在气管和主支气管最为明显，向远端延伸至所有气道，并有干燥的黑色分泌物覆盖。支气管黏膜活检样本和干燥分泌物的组织学检查分别显示为急性支气管炎和坏死碎片。这一发现和患者的病史导致检测血浆尿黑酸，结果发现其升高至12.6微克/毫升，从而首次通过柔性支气管镜检查确诊为尿黑酸尿症。
