Xia Yang, Liang Zhenyu, Fu Zhenzhen, Liu Laiyu, Paudel Omkar, Cai Shaoxi
Chronic Airways Diseases Laboratory, Department of Respiration, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Case Rep Pulmonol. 2012;2012:678249. doi: 10.1155/2012/678249. Epub 2012 Dec 18.
We describe a 51-year-old woman who was admitted to hospital because of cough and expectoration accompanied with general fatigue and progressive dyspnea. Chest HRCT scan showed areas of ground glass attenuation, consolidation, and traction bronchiectasis in bilateral bases of lungs. BAL fluid test and transbronchial lung biopsy failed to offer insightful evidence for diagnosis. She was clinically diagnosed with acute interstitial pneumonia (AIP). Treatment with mechanical ventilation and intravenous application of methylprednisolone (80 mg/day) showed poor clinical response and thus was followed by steroid pulse therapy (500 mg/day, 3 days). However, she died of respiratory dysfunction eventually. Autopsy showed diffuse alveolar damage associated with hyaline membrane formation, pulmonary interstitial, immature collagen edema, and focal type II pneumocyte hyperplasia.
我们描述了一名51岁女性,因咳嗽、咳痰伴全身乏力及进行性呼吸困难入院。胸部高分辨率CT扫描显示双肺底部有磨玻璃影、实变及牵拉性支气管扩张区域。支气管肺泡灌洗术及经支气管肺活检均未能提供有诊断价值的证据。她临床诊断为急性间质性肺炎(AIP)。机械通气及静脉应用甲泼尼龙(80mg/天)治疗临床效果不佳,随后采用冲击疗法(500mg/天,共3天)。然而,她最终死于呼吸功能障碍。尸检显示弥漫性肺泡损伤伴透明膜形成、肺间质未成熟胶原水肿及局灶性II型肺泡上皮细胞增生。