Laudenbach Karen, Seese Bernd
Abteilung Pneumolgie, pneumologische Onkologie, Rehabilitation sowie Schlaf- und Beatmungsmedizin, Thoraxzentrum des Bezirks Unterfranken, Münnerstadt.
Dtsch Med Wochenschr. 2015 Feb;140(4):264-6. doi: 10.1055/s-0041-100353. Epub 2015 Feb 19.
For several months a 29 years old woman suffered from dry cough, dyspnea, and weakness. The clinical examination was without any abnormal findings.
Liver function tests and erythrocyte sedimentation rate were raised. High resolution CT chest scan showed multiple patchy alveolar and interstitial infiltrates. Transbronchial and surgical lung biopsy confirmed a moderate alveolitis with granulomas.
primary biliary cirrhosis (pbc) complicated by lung disease could be diagnosed through increased titer of antimitochondrial antibodies and the laparoscopy.
Under treatment of pbc with either corticosteroids or Ursodeoxycholic acid, liver enzymes decreased and pulmonary symptoms disappeared.
To detect lung involvement in patients with pbc early, lung function tests and diffusion capacity should be monitored regularly. An otherwise unexpected rise in liver function tests, particularly in patients with underlying interstitial lung disease or sarcoid granulomatosis should promptly be investigated further.
一名29岁女性数月来一直干咳、呼吸困难且身体虚弱。临床检查未发现任何异常。
肝功能检查和红细胞沉降率升高。胸部高分辨率CT扫描显示多个斑片状肺泡和间质浸润。经支气管和手术肺活检证实为中度肺泡炎伴肉芽肿。
通过抗线粒体抗体滴度升高和腹腔镜检查可诊断为原发性胆汁性肝硬化（PBC）合并肺部疾病。
在使用皮质类固醇或熊去氧胆酸治疗PBC的过程中，肝酶下降，肺部症状消失。
为早期发现PBC患者的肺部受累情况，应定期监测肺功能检查和弥散能力。对于肝功能检查出现意外升高的情况，尤其是存在潜在间质性肺病或结节病肉芽肿的患者，应立即进一步检查。
