Kondoh Y, Kaneko M, Tanaka H, Nakashima Y, Miyatake H, Shindoh J, Isogai T, Suzuki K, Taki F, Yamaki K
Second Department of Internal Medicine, Nagoya University School of Medicine, Aichi, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Sep;28(9):1245-51.
A 61-year-old man was admitted to our hospital with fever, cough and dyspnea on exertion. The chest X-ray showed diffuse reticulo-granular infiltrates. Deterioration of clinical features and remarkable elevation of BALF lymphocytes (64.3%) suggested active interstitial pneumonia. The open lung biopsy specimen showed chronic interstitial pneumonia with DIP-like pathologic change. There was a remarkable clinical, physiological and roentgenographic improvement associated with decrease of BALF lymphocytes in response to steroid therapy. BAL is useful for monitoring disease activity and tapering steroids in patients with interstitial pneumonia who respond to steroid therapy.
一名61岁男性因发热、咳嗽和劳力性呼吸困难入院。胸部X线显示弥漫性网状颗粒状浸润。临床症状恶化以及支气管肺泡灌洗(BALF)淋巴细胞显著升高(64.3%)提示为活动性间质性肺炎。开胸肺活检标本显示为具有脱屑性间质性肺炎(DIP)样病理改变的慢性间质性肺炎。在接受类固醇治疗后,随着BALF淋巴细胞减少,临床、生理和影像学表现均有显著改善。BAL对于监测间质性肺炎患者的疾病活动以及在对类固醇治疗有反应的患者中逐渐减少类固醇用量很有用。