Soda R, Miyagawa H, Isozima K, Sunami K, Nanba K, Araki M, Okada K, Tuji K, Nakatou K, Tada S
Nihon Kyobu Shikkan Gakkai Zasshi. 1989 Jan;27(1):87-91.
A 54-year-old female with bronchial asthma and PIE syndrome induced by disodium cromoglycate (DSCG) was reported. She was referred to our hospital for further examination of the abnormal chest shadows and eosinophilia. She had been treated with DSCG, Cefaclor. Bromhexine and bronchodilator for bronchial asthma and bronchitis. Withdrawal of the drugs except for the bronchodilators alleviated her symptoms. Therefore, drug induced lymphocytes stimulation tests (DLST) were performed for those three drugs. Only DLST for DSCG showed a positive result. She had been asthmatic for ten years and treated by the drug for 18 months prior to admission. The skin test for the drug was negative and a precipitating antibody for the drug could not be found. To obtain a definite diagnosis, bronchial challenge by DSCG was performed, after her symptoms were under control. Severe asthmatic responses were provoked in 6 and 24 hours after the inhalation of DSCG. Bronchoalveolar lavage, performed 8 days after the provocation, revealed increased eosinophils and lymphocytes in BAL fluid. Although several cases of PIE syndrome induced by DSCG have been reported, this seems to be the first report of late and delayed type bronchial response and pulmonary infiltration with eosinophilia provoked by DSCG. The bronchial response to the drug was a late and delayed type reaction and sustained for a long period. This might indicate that PIE syndrome induced by the drug may be caused by a same mechanism as the provoked asthmatic response.
报道了一名54岁患有支气管哮喘和由色甘酸钠（DSCG）诱发的PIE综合征的女性。她因胸部阴影异常和嗜酸性粒细胞增多被转诊至我院进一步检查。她曾使用DSCG、头孢克洛、溴己新和支气管扩张剂治疗支气管哮喘和支气管炎。停用除支气管扩张剂外的其他药物后症状缓解。因此，对这三种药物进行了药物诱导淋巴细胞刺激试验（DLST）。仅DSCG的DLST呈阳性结果。她患哮喘已十年，入院前使用该药物治疗了18个月。该药物的皮肤试验为阴性，且未发现该药物的沉淀抗体。为明确诊断，在她的症状得到控制后，进行了DSCG支气管激发试验。吸入DSCG后6小时和24小时引发了严重的哮喘反应。激发试验8天后进行的支气管肺泡灌洗显示，支气管肺泡灌洗液中的嗜酸性粒细胞和淋巴细胞增多。尽管已有几例由DSCG诱发的PIE综合征的报道，但这似乎是首例关于DSCG引发的迟发性和延迟型支气管反应及肺嗜酸性粒细胞浸润的报道。该药物的支气管反应为迟发性和延迟型反应，且持续时间较长。这可能表明该药物诱发的PIE综合征可能与诱发的哮喘反应机制相同。
