Khémiri M, Ouederni M, Ben Mansour F, Ben Jaballah N, Barsaoui S
Service de médecine infantile A, hôpital d'Enfants de Tunis, Bab Saadoun, 1007 Tunis, Tunisie.
Ann Fr Anesth Reanim. 2008 Jun;27(6):502-4. doi: 10.1016/j.annfar.2008.04.016. Epub 2008 Jun 18.
Eosinophilic pneumonias are a group of heterogeneous disorders, rarely reported in children. We describe a case of a 12-year-old boy hospitalized for an acute febrile respiratory failure. Chest radiograph showed bilateral diffuse infiltrates. A pulmonary eosinophilic infiltration was confirmed by a major blood eosinophilia at 33,800/mm(3) associated with increased eosinophilic rate (90%) on bronchoalveolar lavage fluid. Outcome improved markedly with mechanical ventilation and corticosteroid therapy. Laboratory screenings for parasitic or allergic disease were negative. Bone marrow smear and medullar caryotype eliminated an acute leukemia. No further visceral eosinophilic injury were found. Acute eosinophilic pneumonia should be included in etiological investigation of patients with acute respiratory distress syndrome (ARDS) even in young subjects.
嗜酸性粒细胞性肺炎是一组异质性疾病,在儿童中很少见。我们描述了一例12岁男孩因急性发热性呼吸衰竭住院的病例。胸部X线片显示双侧弥漫性浸润。支气管肺泡灌洗液中嗜酸性粒细胞率升高(90%),同时外周血嗜酸性粒细胞显著增多至33800/mm³,证实存在肺部嗜酸性粒细胞浸润。机械通气和皮质类固醇治疗后病情明显改善。寄生虫或过敏性疾病的实验室筛查均为阴性。骨髓涂片和核型分析排除了急性白血病。未发现进一步的内脏嗜酸性粒细胞损伤。即使是年轻患者,急性嗜酸性粒细胞性肺炎也应纳入急性呼吸窘迫综合征(ARDS)患者的病因调查中。