支气管肺泡灌洗术中嗜酸性粒细胞计数对变应性支气管肺曲霉病诊断的价值：一例报告
Value of eosinophil count in bronchoalveolar lavage fluid for diagnosis of allergic bronchopulmonary aspergillosis: A case report.
作者信息
Wang Wei-Yi, Wan Shan-Hong, Zheng Yu-Lu, Zhou Ling-Ming, Zhang Hong, Jiang Li-Bin
机构信息
Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China.
Department of Respiratory Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China.
出版信息
World J Clin Cases. 2021 Sep 26;9(27):8142-8146. doi: 10.12998/wjcc.v9.i27.8142.
BACKGROUND
An immediate hypersensitive immune response to antigens is one of the main characteristic features of allergic bronchopulmonary aspergillosis (ABPA). As ABPA is an allergic respiratory disease, immunoglobulin E and peripheral-blood eosinophilia have been used as diagnostic indicators. However, eosinophilia in bronchoalveolar lavage fluid (BALF) has not been considered in the diagnostic criteria for ABPA.
CASE SUMMARY
We present a case of ABPA in which the eosinophil count in peripheral blood was not increased, whereas the eosinophil percentage in BALF reached 60%. After antifungal and hormone therapy, imaging revealed very good resolution of lung infiltration.
CONCLUSION
The value of the eosinophil count in BALF for the diagnosis of ABPA is worthy of the clinician's attention, especially when the patient's clinical features lack specificity and the diagnostic parameters are negative.
背景
对抗原的速发型超敏免疫反应是变应性支气管肺曲霉病（ABPA）的主要特征之一。由于ABPA是一种过敏性呼吸道疾病，免疫球蛋白E和外周血嗜酸性粒细胞增多已被用作诊断指标。然而，支气管肺泡灌洗液（BALF）中的嗜酸性粒细胞增多尚未被纳入ABPA的诊断标准。
病例摘要
我们报告一例ABPA病例，该病例外周血嗜酸性粒细胞计数未升高，而BALF中嗜酸性粒细胞百分比达60%。抗真菌和激素治疗后，影像学显示肺部浸润灶有很好的消散。
结论
BALF中嗜酸性粒细胞计数对ABPA诊断的价值值得临床医生关注，尤其是当患者临床特征缺乏特异性且诊断参数为阴性时。
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