Hase Isano, Kurasawa Kazuhiro, Takizawa Hidenori, Yamaguchi Bunpei, Sakuma Hideo, Ishii Yoshiki
Department of Respiratory Disease, Southern Tohoku General Hospital, Japan.
Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University, Japan.
Intern Med. 2018 Jul 1;57(13):1887-1892. doi: 10.2169/internalmedicine.9679-17. Epub 2018 Feb 9.
Yellow nail syndrome (YNS) pleurisy is often difficult to control, and pathological examinations have rarely been reported. We herein report a case of bucillamine-induced YNS in which histopathology of the parietal pleura revealed hyperplasia of the lymphoid follicles and lymphangiectasia. Even after the discontinuation of bucillamine, the pleurisy and lymphedema showed no change. Based on the histopathological findings showing similarity to rheumatoid pleurisy, we administered corticosteroid treatments, and both the pleurisy and lymphedema improved. The findings in the present case suggest that, in bucillamine-induced YNS, pleurisy may be related to inflammation caused by rheumatoid arthritis in addition to abnormalities in lymphatic vessels.
黄甲综合征（YNS）胸膜炎常难以控制，且病理检查报道较少。我们在此报告1例青霉胺诱发的YNS，其壁层胸膜组织病理学显示淋巴滤泡增生和淋巴管扩张。即使停用青霉胺后，胸膜炎和淋巴水肿仍无变化。基于组织病理学结果显示与类风湿性胸膜炎相似，我们给予了皮质类固醇治疗，胸膜炎和淋巴水肿均得到改善。本例结果提示，在青霉胺诱发的YNS中，胸膜炎除淋巴管异常外，可能还与类风湿关节炎引起的炎症有关。
