Department of Pulmonary Medicine and Clinical Immunology, Dokkyo University School of Medicine, Tochigi, Japan.
Allergol Int. 2010 Mar;59(1):87-91. doi: 10.2332/allergolint.09-CR-0114. Epub 2010 Nov 25.
A 56-year-old woman was referred to our hospital because of dyspnea, wheezing, and a productive cough. Eight years before presentation, bronchial asthma was diagnosed and the patient received inhaled corticosteroids plus antiasthmatic agents (a long-acting inhaled beta2-agonist, leukotriene modifiers, and theophylline). Chest radiography showed small diffuse nodular shadows, and a computed tomographic scan showed thickening of the bronchi and bronchioles, with diffuse centrilobular nodules in both lung fields. A blood test and microscopic examination of the bronchoalveolar fluid revealed marked eosinophilia. Transbronchial lung biopsy and transbronchial biopsy showed eosinophilic bronchitis and bronchiolitis. After treatment with oral prednisolone (40 mg daily) and inhaled corticosteroids, the symptoms, blood eosinophilia, and radiographic findings improved. Recently, several similar cases of eosinophilic bronchiolitis have been reported. Studies of further cases and elucidation of the pathophysiology of eosinophilic bronchiolitis are necessary to establish a concept for this disease and to determine whether it should be classified as a subtype of bronchial asthma or as a distinct entity.
一位 56 岁女性因呼吸困难、喘息和咳痰就诊于我院。8 年前，该患者被诊断为支气管哮喘，并接受了吸入皮质激素加抗哮喘药物（长效吸入β2-激动剂、白三烯调节剂和茶碱）治疗。胸部 X 线显示弥漫性小结节状阴影，计算机断层扫描显示支气管和细支气管增厚，双肺野弥漫性中心性小叶结节。血液检查和支气管肺泡液的显微镜检查显示明显的嗜酸性粒细胞增多。经支气管肺活检和经支气管活检显示嗜酸性细支气管炎和细支气管炎。口服泼尼松龙（40mg/d）和吸入皮质激素治疗后，症状、血嗜酸性粒细胞增多和影像学发现均得到改善。最近，有几例类似的嗜酸性细支气管炎报告。需要进一步研究病例并阐明嗜酸性细支气管炎的病理生理学，以确定是否应将其归类为支气管哮喘的一个亚型或作为一个独立的实体。
