Israel-Biet D, Venet A, Sandron D, Ziza J M, Chretien J
Am Rev Respir Dis. 1987 Mar;135(3):763-5. doi: 10.1164/arrd.1987.135.3.763.
Lungs have rarely been reported to be affected by any side effects of BCG therapy. Interstitial pneumonitis, though, is known to occur under such circumstances, but its pathogenesis is still debated between an infectious and a hypersensitivity mechanism. We report here 3 cases of pulmonary complications of BCG therapy evaluated by bronchoalveolar lavage (BAL). Cellular data obtained from all 3 patients were characterized by a markedly increased alveolar lymphocytosis. The T4/T8 ratio was elevated compared with that in normal subjects and with the T4/T8 ratio of circulating lymphocytes. Furthermore, alveolar lymphocytes were highly sensitized to PPD, as evaluated by their proliferation and their production of interleukin 2 in the presence of PPD. Mycobacteria were not found in the 3 patients. We conclude that interstitial pneumonitis occurring during BCG therapy could be explained by a hypersensitivity phenomenon, leading to an intense immune and lymphocyte-mediated response within involved organs.
卡介苗（BCG）治疗的副作用很少累及肺部。不过，已知在这种情况下会发生间质性肺炎，但其发病机制在感染性机制和超敏反应机制之间仍存在争议。我们在此报告3例通过支气管肺泡灌洗（BAL）评估的卡介苗治疗肺部并发症病例。所有3例患者的细胞数据均表现为肺泡淋巴细胞显著增多。与正常受试者及循环淋巴细胞的T4/T8比值相比，其T4/T8比值升高。此外，通过肺泡淋巴细胞在存在结核菌素纯蛋白衍生物（PPD）时的增殖及白细胞介素2的产生情况评估，发现肺泡淋巴细胞对PPD高度敏感。3例患者中均未发现分枝杆菌。我们得出结论，卡介苗治疗期间发生的间质性肺炎可能由超敏现象解释，导致受累器官内强烈的免疫和淋巴细胞介导反应。
