Teixeira Natália, Santos Maria Inês, Pedro Filipa, Pinto Maria João, Mestre Ana
Internal Medicine, Hospital Distrital de Santarém, Santarém, PRT.
Cureus. 2021 Mar 22;13(3):e14047. doi: 10.7759/cureus.14047.
Idiopathic chronic eosinophilic pneumonia (CEP) is a rare disease of unknown cause characterized by eosinophilic alveolar and interstitial infiltration. The authors describe the case of a 46-year-old black man, presenting with insidious onset and progressive course of dyspnea on minimum exertion, cough, fever, night sweats, and weight loss for one year and worsening in the last three months. The main findings were serum eosinophilia. Chest radiographs showed multifocal infiltrations of irregular distribution in both lungs and a restrictive functional impairment. The patient underwent open lung biopsy, and the anatomopathological examination revealed consolidation by exudate constituted predominantly by macrophages (25%) and eosinophils (51%), which filled small air spaces, including respiratory and membranous bronchioles. The anatomopathological diagnosis was eosinophilic pneumonia (eosinophils > 25% is widely accepted for diagnosing eosinophilic pneumonia). The patient had a good clinical response after starting corticosteroid therapy.
特发性慢性嗜酸性粒细胞性肺炎（CEP）是一种病因不明的罕见疾病，其特征为嗜酸性粒细胞在肺泡和间质浸润。作者描述了一名46岁黑人男性的病例，该患者起病隐匿，在轻微活动时即出现进行性呼吸困难、咳嗽、发热、盗汗和体重减轻达一年，且在过去三个月病情加重。主要发现为血清嗜酸性粒细胞增多。胸部X线片显示双肺多发不规则分布的浸润影以及限制性功能障碍。患者接受了开胸肺活检，解剖病理学检查显示渗出物导致实变，渗出物主要由巨噬细胞（25%）和嗜酸性粒细胞（51%）组成，这些细胞充满了包括呼吸性细支气管和膜性细支气管在内的小气道。解剖病理学诊断为嗜酸性粒细胞性肺炎（嗜酸性粒细胞>25%被广泛接受为诊断嗜酸性粒细胞性肺炎的标准）。患者在开始使用皮质类固醇治疗后临床反应良好。
