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[特发性嗜酸性粒细胞性胸腔积液——病例报告]

[Idiopathic eosinophilic pleural effusion--case report].

作者信息

Mitrović Josko, Anić Branimir, Vergles Jadranka Morović

机构信息

Zavod za klinicku imunologiju i reumatologiju Klinike za unutarnje bolesti Medicinskog fakulteta Sveucilista u Zagrebu, KB Dubrava, Zagreb.

出版信息

Lijec Vjesn. 2012 Jul-Aug;134(7-8):215-7.

Abstract

Eosinophilic pleural effusion (EPE) is defined as exudative effusion that contains at least 10% eosinophils. The most common conditions associated with EPE are malignancy, infections, post-traumatic and post-surgical conditions, hypersensitivity, systemic autoimmune diseases, congestive heart failure, cirrhosis, pulmonary embolus, asbestosis and drug induced EPE. Pleural effusion accompanying autoimmune diseases is most common in patients with systemic lupus erythematosus, rheumatoid arthritis, howewer it rarely occurs in patients with progressive systemic sclerosis and polymiositis. EPE has rarely been reported in association with Churg Strauss syndrome. In about 14-25% of patients EPE can be defined as idiopathic when diagnostic procedures failed to identify the etiology. Treatment of EPE is based on the treatment of primary disease and with idiopathic form a good answer is reached using glucocorticoids. In this case report we presented the patient with idiopathic eosinophilic pleural effusion where in diagnostic procedures we excluded other diseases or conditions in which EPE can be shown, and with applied therapy with methylprednisolone we achieved excellent clinical response and final healing.

摘要

嗜酸性胸腔积液(EPE)被定义为含有至少10%嗜酸性粒细胞的渗出性胸腔积液。与EPE相关的最常见情况包括恶性肿瘤、感染、创伤后和手术后情况、超敏反应、系统性自身免疫性疾病、充血性心力衰竭、肝硬化、肺栓塞、石棉沉着病和药物性EPE。自身免疫性疾病伴发的胸腔积液在系统性红斑狼疮、类风湿关节炎患者中最为常见,然而在进行性系统性硬化症和多发性肌炎患者中很少发生。很少有关于EPE与Churg Strauss综合征相关的报道。在约14% - 25%的患者中,当诊断程序未能确定病因时,EPE可被定义为特发性。EPE的治疗基于对原发疾病的治疗,对于特发性形式,使用糖皮质激素可取得良好效果。在本病例报告中,我们介绍了一名特发性嗜酸性胸腔积液患者,在诊断程序中我们排除了其他可出现EPE的疾病或情况,并且通过应用甲泼尼龙治疗,我们取得了出色的临床反应并最终治愈。

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