Jankowska Ewa, Bartoszuk Iwona, Lewandowska Katarzyna, Dybowska Małgorzata, Opoka Lucyna, Tomkowski Witold, Szturmowicz Monika
1st Department of Lung Diseases, National Research Institute of Tuberculosis and Lung Diseases, 01-138 Warsaw, Poland.
Department of Radiology, National Research Institute of Tuberculosis and Lung Diseases, 01-138 Warsaw, Poland.
Diagnostics (Basel). 2022 Jun 9;12(6):1425. doi: 10.3390/diagnostics12061425.
Acute Eosinophilic Pneumonia (AEP) is a rare idiopathic disease caused by an accumulation of eosinophils in the pulmonary alveoli and interstitial tissue of the lungs. The onset of symptoms is acute; some patients develop respiratory failure. The diagnosis is based on clinical symptoms, diffuse interstitial infiltrates in the lungs on imaging studies, and eosinophilia exceeding 25% on bronchoalveolar lavage or pleural fluid smear. Smokers are primarily at increased risk for the disease. We present a case of venous thromboembolic disease (VTE) that developed in the course of AEP in a previously healthy male smoker. Complete remission of the disease was achieved with anticoagulation therapy combined with a low dose of steroids. Surprisingly, further diagnostics revealed the presence of thrombophilia: antithrombin (AT) deficiency and increased homocysteine level. According to our knowledge, this is the first case of VTE diagnosed in the course of AEP combined with thrombophilia.
急性嗜酸性粒细胞性肺炎（AEP）是一种罕见的特发性疾病，由嗜酸性粒细胞在肺泡和肺间质组织中积聚所致。症状起病急；部分患者会发展为呼吸衰竭。诊断基于临床症状、影像学检查显示肺部弥漫性间质浸润，以及支气管肺泡灌洗或胸腔积液涂片显示嗜酸性粒细胞增多超过25%。吸烟者患该病的风险主要更高。我们报告一例静脉血栓栓塞性疾病（VTE），发生在一名既往健康的男性吸烟者的AEP病程中。抗凝治疗联合低剂量类固醇使疾病完全缓解。令人惊讶的是，进一步检查发现存在易栓症：抗凝血酶（AT）缺乏和同型半胱氨酸水平升高。据我们所知，这是首例在AEP病程中诊断出VTE并合并易栓症的病例。
