Sasaki Hisashi, Miyata Jun, Maki Yohei, Kimizuka Yoshifumi, Hayashi Nobuyoshi, Fujikura Yuji, Kawana Akihiko
Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Japan.
Intern Med. 2019 Oct 1;58(19):2835-2838. doi: 10.2169/internalmedicine.2785-19. Epub 2019 Jun 27.
Allergic bronchopulmonary aspergillosis (ABPA) is an eosinophilic inflammatory condition characterized by exaggerated immune responses to the fungal genus Aspergillus. Pulmonary manifestations in patients with Crohn's disease (CD) are frequent comorbidities. A 66-year-old man with CD treated with an anti-tumor necrosis factor-α antibody presented with dyspnea. Laboratory findings of elevated blood eosinophils and total serum IgE and positive aspergillus-specific antibodies as well as imaging findings of central bronchiectasis and mucoid impaction indicated a diagnosis of ABPA. To our knowledge, this is the first report of ABPA arising in a patient with CD. We discuss the pathophysiological mechanism of this rare complication.
变应性支气管肺曲霉病(ABPA)是一种嗜酸性粒细胞性炎症性疾病,其特征是对曲霉属真菌产生过度免疫反应。克罗恩病(CD)患者的肺部表现是常见的合并症。一名66岁接受抗肿瘤坏死因子-α抗体治疗的CD男性患者出现呼吸困难。血液嗜酸性粒细胞增多、血清总IgE升高以及曲霉特异性抗体阳性的实验室检查结果,以及中央支气管扩张和黏液嵌塞的影像学检查结果提示ABPA诊断。据我们所知,这是首例CD患者发生ABPA的报告。我们讨论了这种罕见并发症的病理生理机制。