Kroegel C, Foerster M, Quickert S, Slevogt H, Neumann T
Abt. Pneumologie & Allergologie/Immunologie, Medizinische Klinik I, Klinikum der Universität Jena, Am Klinikum 1, 07740, Jena, Deutschland.
Abt. Gastroenterologie, Hepatologie, Infektiologie, Klinik für Innere Medizin IV, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.
Z Rheumatol. 2018 Dec;77(10):907-922. doi: 10.1007/s00393-018-0561-z.
Eosinophilic granulocytes form peripheral effector cells controlled by Th2 lymphocytes, which cause local cell, tissue, and functional disorders of infiltrated organs via the release of cytotoxic basic proteins and oxygen radicals. Diseases associated with eosinophilia include systemic and organ-related forms. The lungs are involved in eosinophilic granulomatosis with polyangiitis (EGPA, formerly known as Churg-Strauss syndrome), acute and chronic eosinophilic pneumonia, as well as in an organ manifestation in hypereosinophilic syndrome and certain parasitic diseases. In particular, the lungs are frequently affected in vasculitis of small vessels, including EGPA, granulomatosis with polyangiitis (GPA), and microscopic polyangiitis (MPA). Among these, EGPA is the most frequent pulmonary eosinophil vasculitis representative. In addition, there are various overlap syndromes in which characteristic features of EGPA can be detected in the context of other anti-neutrophil cytoplasmic antibody (ANCA-)associated vasculitides. Occasionally, non-ANCA-associated pulmonary vasculitides occur with eosinophilia (e.g., Schönlein-Henoch purpura, Kawasaki disease, drug-induced hypersensitivity, and paraneoplastic syndrome). Herein, the pulmonary vasculitides accompanying eosinophilia are presented with respect to both the lung manifestations and pulmonary eosinophilia.
嗜酸性粒细胞形成由Th2淋巴细胞控制的外周效应细胞,Th2淋巴细胞通过释放细胞毒性碱性蛋白和氧自由基导致浸润器官出现局部细胞、组织和功能紊乱。与嗜酸性粒细胞增多相关的疾病包括全身性和器官相关形式。肺部会出现嗜酸性肉芽肿性多血管炎(EGPA,以前称为Churg-Strauss综合征)、急慢性嗜酸性粒细胞性肺炎,以及高嗜酸性粒细胞综合征和某些寄生虫病的器官表现。特别是,肺部在小血管炎中经常受到影响,包括EGPA、肉芽肿性多血管炎(GPA)和显微镜下多血管炎(MPA)。其中,EGPA是最常见的肺部嗜酸性粒细胞血管炎代表。此外,还有各种重叠综合征,在其他抗中性粒细胞胞浆抗体(ANCA)相关血管炎的背景下可检测到EGPA的特征。偶尔,非ANCA相关的肺部血管炎也会伴有嗜酸性粒细胞增多(如过敏性紫癜、川崎病、药物性超敏反应和副肿瘤综合征)。在此,就肺部表现和肺部嗜酸性粒细胞增多而言,介绍伴有嗜酸性粒细胞增多的肺部血管炎。