Man Milena Adina, Man Sorin Claudiu, Motoc Nicoleta Ştefania, Pop Carmen Monica, Trofor Antigona Carmen
Department of Mother and Child, Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania;
Rom J Morphol Embryol. 2017;58(2):627-634.
Hypersensitivity pneumonitis (HP; extrinsic allergic alveolitis) is a rare non-immunoglobulin E (IgE)-mediated inflammatory lung disease caused by inhalation exposure (occupational, recreational or ordinary home exposure). A 36-year-old female patient, without significant medical history, is referred to an outpatient pulmonology clinic for dry cough, shortness of breath, fever, fatigue and weight loss. Chest high-resolution computed tomography (HRCT) was performed, and significant lung fibrosis (especially centrilobular and interlobular in bilateral "thick lines"), traction bronchiectasis and alveolitis in both superior lobes are described. Lung function tests showed severe restrictive dysfunction. Transfer factor of the lung for carbon monoxide (TLCO) being very low, the flexible bronchoscopy was contraindicated. Surgical lung biopsy was performed. Histopathological examination showed characteristic lesions of chronic bilateral hypersensitivity pneumonitis. The patient died four days after the surgical intervention due to post-operative complications. Exposure to various chemical substances can form bonds with human proteins molecules and induce an exaggerated immune response in susceptible individuals. A high index of suspicion of occupational exposure can determine an early diagnosis with a better outcome.
过敏性肺炎（HP；外源性过敏性肺泡炎）是一种罕见的非免疫球蛋白E（IgE）介导的炎症性肺部疾病，由吸入暴露（职业性、娱乐性或普通家庭暴露）引起。一名36岁女性患者，无重大病史，因干咳、气短、发热、乏力和体重减轻被转诊至门诊肺科诊所。进行了胸部高分辨率计算机断层扫描（HRCT），描述了明显的肺纤维化（尤其是双侧“粗线”中的小叶中心和小叶间）、牵引性支气管扩张以及两上叶的肺泡炎。肺功能测试显示严重的限制性功能障碍。由于肺一氧化碳转运因子（TLCO）非常低，禁忌进行柔性支气管镜检查。进行了外科肺活检。组织病理学检查显示慢性双侧过敏性肺炎的特征性病变。患者在手术干预四天后因术后并发症死亡。接触各种化学物质可与人蛋白质分子形成键，并在易感个体中引发过度的免疫反应。高度怀疑职业暴露可实现早期诊断并获得更好的结果。
