Chiba Shigeki, Okada Shinji, Suzuki Yasuko, Watanuki Zenta, Mitsuishi Yoichiro, Igusa Ryotaro, Sekii Takehiko, Uchiyama Bine
South Miyagi Medical Center, Miyagi.
Intern Med. 2009;48(5):363-7. doi: 10.2169/internalmedicine.48.1811. Epub 2009 Mar 2.
Home-related chronic hypersensitivity pneumonitis (HP) is sometimes difficult to discriminate because patients do not have an obvious history of antigen exposure. We report two HP cases which developed in an office area and in a home: a 47-year-old woman with acute-onset HP and a 72-year-old woman with chronic HP followed up as idiopathic pulmonary fibrosis following isolation of Cladosporium cladosporioides and Cladosporium herbarum, respectively. Lymphocyte stimulating activity and antibody titer to these fungi were increased in these patients. Since Cladosporium spp. and several other fungi are present ubiquitously in our living environment, it is difficult to eliminate the antigen from the patients' environment to control the disease. Cladosporium spp. can be key antigens in inducing chronic HP in the home environment.
与家庭相关的慢性过敏性肺炎（HP）有时难以鉴别，因为患者没有明显的抗原接触史。我们报告了两例分别在办公区域和家中发生的HP病例：一例是一名47岁急性起病的女性患者，另一例是一名72岁的慢性HP女性患者，在分别分离出枝孢菌和草本枝孢菌后，最初被误诊为特发性肺纤维化进行随访。这些患者针对这些真菌的淋巴细胞刺激活性和抗体滴度均升高。由于枝孢菌属和其他几种真菌在我们的生活环境中普遍存在，因此很难从患者环境中消除抗原以控制疾病。枝孢菌属可能是在家居环境中诱发慢性HP的关键抗原。
