Tomyo Fuminori, Sugimoto Naoya, Kawamoto Masashi, Nagase Hiroyuki, Yamaguchi Masao, Ohta Ken
Division of Respiratory Medicine and Allergology, Department of Medicine Teikyo University School of Medicine Tokyo Japan.
Department of Diagnostic Pathology Teikyo University Mizonokuchi Hospital Kawasaki Japan.
Respirol Case Rep. 2018 Dec 18;7(2):e00397. doi: 10.1002/rcr2.397. eCollection 2019 Feb.
A 60-year-old female with severe bronchial asthma developed persistent dyspnoea and an abnormal lung shadow. High-resolution computed tomography (HRCT) demonstrated patchy ground-glass opacities and diffuse, small nodular shadows. Elevated percentages of eosinophils were observed in the blood and bronchoalveolar lavage fluid. These results collectively indicated that her asthma was accompanied by eosinophilic pneumonia and eosinophilic bronchiolitis. Although previous, rare case reports suggest that systemic steroid therapy is necessary and effective for the control of eosinophilic bronchiolitis, we chose to treat her with an anti-interleukin 5 antibody, mepolizumab. Her asthma, eosinophilic pneumonia, and eosinophilic bronchiolitis each improved in response to mepolizumab as assessed from her symptoms, pulmonary function tests, and HRCT. Mepolizumab might be effective not only for asthma and eosinophilic pneumonia but also for eosinophilic bronchiolitis.
一名60岁患有严重支气管哮喘的女性出现持续性呼吸困难和肺部异常阴影。高分辨率计算机断层扫描（HRCT）显示斑片状磨玻璃影和弥漫性小结节影。血液和支气管肺泡灌洗液中嗜酸性粒细胞百分比升高。这些结果共同表明她的哮喘伴有嗜酸性粒细胞性肺炎和嗜酸性粒细胞性细支气管炎。尽管先前罕见的病例报告表明全身类固醇治疗对于控制嗜酸性粒细胞性细支气管炎是必要且有效的，但我们选择用抗白细胞介素5抗体美泊利珠单抗对她进行治疗。从她的症状、肺功能测试和HRCT评估来看，她的哮喘、嗜酸性粒细胞性肺炎和嗜酸性粒细胞性细支气管炎对美泊利珠单抗均有改善。美泊利珠单抗可能不仅对哮喘和嗜酸性粒细胞性肺炎有效，而且对嗜酸性粒细胞性细支气管炎也有效。
