Natali D, Tulliez M, Burgel P-R, Mouthon L, Dusser D, Montani D
Service de pneumologie, faculté de médecine Paris-Descartes, université Paris-Descartes, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France.
Rev Pneumol Clin. 2008 Oct;64(5):229-33. doi: 10.1016/j.pneumo.2007.12.001. Epub 2008 Oct 23.
Eosinophilic pleural effusion (EPE) is defined as pleural eosinophilia greater than 10%. EPE can be seen in almost all conditions that can cause pleural effusion, but some aetiologies have to be investigated due to their frequency or potential severity. The most common aetiology of EPE is the presence of air or blood in the pleural cavity. Other frequent aetiologies include bacterial pneumonia, tuberculosis, parasitic disease and certain drugs. Although often considered to be a sign of a benign condition, pleural eosinophilia may be associated with malignancies. EPE may also indicate the presence of Churg and Strauss syndrome. We report the case of a 27-year-old man, in whom the exploration of EPE led to the diagnosis of Churg and Strauss syndrome with the association of asthma, blood and alveolar eosinophilia, myopericarditis and positive antineutrophil cytoplasmic antibodies (ANCA). This case report enables us to discuss the different causes of EPE and to illustrate how it may be a manifestation of Churg and Strauss syndrome.
嗜酸性胸腔积液(EPE)定义为胸腔嗜酸性粒细胞增多超过10%。几乎在所有可导致胸腔积液的情况下都能见到EPE,但由于某些病因的发生频率或潜在严重性,必须对其进行调查。EPE最常见的病因是胸腔内存在空气或血液。其他常见病因包括细菌性肺炎、肺结核、寄生虫病和某些药物。尽管胸腔嗜酸性粒细胞增多通常被认为是良性疾病的体征,但它可能与恶性肿瘤有关。EPE也可能提示存在Churg-Strauss综合征。我们报告一例27岁男性病例,对其EPE的检查导致诊断为Churg-Strauss综合征,伴有哮喘、血液和肺泡嗜酸性粒细胞增多、心肌心包炎以及抗中性粒细胞胞浆抗体(ANCA)阳性。该病例报告使我们能够讨论EPE的不同病因,并说明它如何可能是Churg-Strauss综合征的一种表现。