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常规卷烟和加热不燃烧卷烟联合使用后出现急性嗜酸性粒细胞性肺炎:病例报告。

Acute Eosinophilic Pneumonia after Combined Use of Conventional and Heat-Not-Burn Cigarettes: A Case Report.

机构信息

Department of Internal Medicine, Dong-A University College of Medicine, Busan 49241, Korea.

Department of Pathology, Dong-A University College of Medicine, Busan 49241, Korea.

出版信息

Medicina (Kaunas). 2022 Oct 26;58(11):1527. doi: 10.3390/medicina58111527.

DOI:10.3390/medicina58111527
PMID:36363483
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9695061/
Abstract

: Acute eosinophilic pneumonia (AEP) is a rare acute respiratory disease accompanied by fever, shortness of breath, and cough. Although the pathogenesis of the disease is not yet established, the patient's condition improves with a rapid therapeutic response to systemic corticosteroids. Conventional cigarettes or heat-not-burn cigarettes are the most common cause of AEP among young people. : A 22-year-old woman with dyspnea, cough, and fever did not improve after visiting the local medical center and was admitted to the emergency room. The patient denied having any recent travel history or insect bites. She was treated with appropriate antibiotics according to the community acquired pneumonia, but there was no improvement. Chest radiography showed bilateral patches of pulmonary infiltration, and chest computed tomography revealed bilateral multifocal patchy consolidations with multiple small nodular ground-glass opacities and interlobular septal thickening. The bronchoalveolar lavage result was dominantly eosinophilic. The patient's condition improved rapidly after the use of intravenous methylprednisolone and then a change to oral methylprednisolone. Finally, the patient was hospitalized for 9 days, and the duration of use of methylprednisolone including outpatient visits was 14 days. : The early treatment of AEP yields a good prognosis, but since the symptoms of AEP are similar to those of infectious diseases such as community-acquired pneumonia, physicians should be meticulous in differentiating AEP from other diseases. : Since AEP shows a good response to steroids, early detection using an appropriate diagnostic method is recommended. In addition, there should be strong education against smoking in any form.

摘要

急性嗜酸性粒细胞肺炎(AEP)是一种罕见的急性呼吸道疾病,伴有发热、呼吸急促和咳嗽。尽管该病的发病机制尚未确定,但患者的病情会随着全身性皮质类固醇的快速治疗反应而改善。在年轻人中,常规香烟或加热不燃烧香烟是 AEP 最常见的原因。

一名 22 岁女性因呼吸困难、咳嗽和发热在当地医疗中心就诊后未见改善,随后被收入急诊病房。患者否认有近期旅行史或虫咬史。根据社区获得性肺炎,她接受了适当的抗生素治疗,但病情没有改善。胸部 X 线检查显示双侧斑片状肺浸润,胸部计算机断层扫描显示双侧多灶性斑片状实变,伴有多个小结节状磨玻璃影和小叶间隔增厚。支气管肺泡灌洗液结果以嗜酸性粒细胞为主。患者在使用静脉甲基强的松龙后病情迅速改善,然后改为口服甲基强的松龙。最终,患者住院 9 天,包括门诊在内使用甲基强的松龙的时间为 14 天。

AEP 的早期治疗预后良好,但由于 AEP 的症状与社区获得性肺炎等传染病相似,医生应仔细将 AEP 与其他疾病区分开来。

由于 AEP 对类固醇反应良好,建议使用适当的诊断方法尽早发现。此外,应大力开展任何形式吸烟危害的教育。

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