Tamm Allison M, Kremens Karol
Essentia Health, Fargo, North Dakota,
Essentia Health, Fargo, North Dakota.
WMJ. 2019 Jul;118(2):95-97.
Hypersensitivity pneumonitis is a complex syndrome characterized by non-Immunoglobulin E-mediated inflammation of lung parenchyma in response to an antigen.
A 60-year-old white man presented with acute onset of hypoxia, dyspnea, and nonproductive cough. After extensive workup, he was diagnosed with hypersensitivity pneumonitis. We present the case of a patient with refractory hypersensitivity pneumonitis not responsive to standard immunosuppressive therapy, who was successfully treated with rituximab.
Hypersensitivity pneumonitis is a multifaceted syndrome characterized by an exaggerated immune-mediated response to an antigen. Currently, the most common treatment for an acute exacerbation of the syndrome is withdrawal of the offending antigen and systemic corticosteroids. However, despite their widespread use, the efficacy of steroids in treating acute hypersensitivity pneumonitis is poor.
Rituximab could be considered as a salvage therapy in cases of severe hypersensitivity pneumonitis unresponsive to standard therapy, especially in patients with high risk of death.
过敏性肺炎是一种复杂的综合征，其特征是肺实质对一种抗原产生非免疫球蛋白E介导的炎症反应。
一名60岁白人男性出现急性缺氧、呼吸困难和干咳。经过全面检查，他被诊断为过敏性肺炎。我们报告了一例对标准免疫抑制治疗无反应的难治性过敏性肺炎患者，该患者接受利妥昔单抗治疗成功。
过敏性肺炎是一种多方面的综合征，其特征是对一种抗原产生过度的免疫介导反应。目前，该综合征急性加重的最常见治疗方法是去除致病抗原和使用全身性皮质类固醇。然而，尽管皮质类固醇广泛使用，但其治疗急性过敏性肺炎的疗效不佳。
对于对标准治疗无反应的严重过敏性肺炎病例，尤其是有高死亡风险的患者，可考虑将利妥昔单抗作为挽救治疗方法。
