Hachisu Yoshimasa, Koga Yasuhiko, Sunaga Noriaki, Kashiwagi Chiharu, Sawada Yuri, Saito Yasuyuki, Tsukagoshi Yusuke, Kasahara Norimitsu, Sakurai Reiko, Tsurumaki Hiroaki, Yatomi Masakiyo, Kaira Kyoichi, Ono Akihiro, Maeno Toshitaka, Hisada Takeshi
Division of Allergy and Respiratory Medicine, Gunma University Graduate School of Medicine, Japan.
Oncology Center, Gunma University Hospital, Gunma University Graduate School of Medicine, Japan.
Intern Med. 2018 Jan 15;57(2):247-251. doi: 10.2169/internalmedicine.8955-17. Epub 2017 Nov 1.
A 66-year-old man had been treated with prednisolone for eosinophilic pneumonia for 8 years. His slowly progressing cough and dyspnea were accompanied by elevated levels of fibrotic serological markers and an increased reticular shadow on chest computed tomography images. The patient had recently tested positive for anti-EJ antibodies, a type of anti-aminoacyl-tRNA synthetase antibody; therefore, we diagnosed him with an exacerbation of interstitial pneumonia due to anti-synthetase syndrome (ASS). He was treated with tacrolimus and an increased prednisolone dosage. We herein present the first reported case of eosinophilic pneumonia preceding anti-EJ antibody-positive ASS.
一名66岁男性因嗜酸性粒细胞性肺炎接受泼尼松龙治疗8年。他缓慢进展的咳嗽和呼吸困难伴有纤维化血清学标志物水平升高以及胸部计算机断层扫描图像上网状阴影增加。该患者最近抗EJ抗体检测呈阳性,抗EJ抗体是一种抗氨酰tRNA合成酶抗体;因此,我们诊断他为抗合成酶综合征(ASS)导致的间质性肺炎加重。他接受了他克莫司治疗和泼尼松龙剂量增加的治疗。我们在此报告首例抗EJ抗体阳性的ASS之前发生嗜酸性粒细胞性肺炎的病例。