Bogaerts Y, Van Renterghem D, Vanvuchelen J, Praet M, Michielssen P, Blaton V, Willemot J P
Algemeen Ziekenhuis Sint-Jan, Brugge, Belgium.
Eur Respir J. 1991 Sep;4(8):1033-6.
A case is presented of interstitial pneumonitis and pulmonary vasculitis ascribed to the ingestion of an L-tryptophan preparation. An unintended rechallenge supported the causal relationship. There was neither myalgia nor peripheral eosinophilia. Bronchoalveolar lavage fluid contained 12% eosinophils but few were present in the surgical lung biopsy specimen. Lung infiltrates receded after withdrawal of the drug and treatment with steroids. Dyspnoea and pulmonary hypertension persisted. Cyclophosphamide had no effect. Sclerodermiform skin lesions appeared as a late sequel. Chromatographic analysis of the L-tryptophan revealed no suspect impurities.
本文报告一例因摄入L-色氨酸制剂导致的间质性肺炎和肺血管炎病例。一次意外的再激发试验支持了因果关系。患者既无肌痛也无外周嗜酸性粒细胞增多。支气管肺泡灌洗液中嗜酸性粒细胞占12%，但手术肺活检标本中嗜酸性粒细胞较少。停用该药物并使用类固醇治疗后，肺部浸润消退。呼吸困难和肺动脉高压持续存在。环磷酰胺无效。硬皮病样皮肤病变作为晚期后遗症出现。对L-色氨酸的色谱分析未发现可疑杂质。
