Sugiyama Kanako, Mukae Hiroshi, Ishii Hiroshi, Ide Mioko, Ishimoto Hiroshi, Kakugawa Tomoyuki, Hisatomi Keiko, Nakayama Seiko, Shirai Ryo, Miyazaki Yoshitsugu, Kohno Shigeru
Secone Depertment of Internal Medicine, Nagasaki University School of Medicine.
Nihon Kokyuki Gakkai Zasshi. 2005 Nov;43(11):683-8.
A 37-year-old-woman was admitted to our hospital because of chest bilateral reticular shadow with fever, cough, general malaise and exertional dyspnea in the summer. A diagnosis of summer-type hypersensitivity pneumonitis (SHP) was made by radiological, serological and histological examinations. Her 10-year-old daughter had chest reticular shadows and similar symptoms. These two patients were positive for serum anti-Trichosporon cutaneum (T. asahii, T. mucoides) antibodies and T. asahii was identified from cultured samples obtained from their house. They recovered spontaneously after hospitalization or isolation from the antigen. We reviewed the clinical features in sixteen families with familial SHP reported in Japan. Children aged under 15 years old accounted for 34% and there was no gender difference among patients. This finding differs from the conventionally defined features of patients with SHP. Measurements of serum KL-6, SP-D and SP-A seem to be useful for auxiliary diagnosis and monitoring the disease activity of SHP, especially in pediatric cases who cannot undergo invasive evaluation.
一名37岁女性因夏季出现双侧胸部网状阴影、发热、咳嗽、全身乏力及劳力性呼吸困难而入院。通过放射学、血清学和组织学检查确诊为夏季型过敏性肺炎（SHP）。她10岁的女儿也有胸部网状阴影及类似症状。这两名患者血清抗皮状丝孢酵母菌（浅白隐球菌、粘液丝孢酵母菌）抗体呈阳性，且从其家中采集的培养样本中鉴定出了浅白隐球菌。她们在住院或脱离抗原后自行康复。我们回顾了日本报道的16个家族性SHP家庭的临床特征。15岁以下儿童占34%，患者之间无性别差异。这一发现与传统定义的SHP患者特征不同。血清KL-6、SP-D和SP-A的检测似乎有助于SHP的辅助诊断和疾病活动监测，尤其是在无法进行侵入性评估的儿科病例中。
