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病例报告:变应性支气管肺曲霉病和热带肺嗜酸性粒细胞增多症同时发生,误诊为难治性变应性支气管肺曲霉病。

Case Report: Allergic Bronchopulmonary Aspergillosis and Tropical Pulmonary Eosinophilia Co-Occurrence Masquerading as Refractory Allergic Bronchopulmonary Aspergillosis.

机构信息

Department of Pulmonary Medicine, Command Hospital (NC), Udhampur, India.

Department of Ophthalmology, Command Hospital (NC), Udhampur, India.

出版信息

Am J Trop Med Hyg. 2024 Feb 13;110(3):509-511. doi: 10.4269/ajtmh.23-0450. Print 2024 Mar 6.

Abstract

Pulmonary infiltrates with eosinophilia are a heterogeneous group of disorders that are characterized by pulmonary infiltrates on chest radiograph and elevated levels of eosinophils in the peripheral blood. Among patients with these disorders, reports of either allergic bronchopulmonary aspergillosis (ABPA) or tropical pulmonary eosinophilia (TPE) are common. However, the simultaneous occurrence of ABPA and TPE is not often reported. We present the case of a young man with a history of asthma who was diagnosed with ABPA and TPE. Initially, the patient exhibited a partial response to treatment of ABPA, but persistent symptoms and eosinophilia led to suspicion and subsequent diagnosis of TPE. With implementation of antifilarials and steroids, the patient experienced satisfactory clinical and serological improvements. This case underscores the importance of considering multiple diagnoses in patients with overlapping symptoms and highlights the need for comprehensive management strategies in complex lung diseases.

摘要

肺浸润伴嗜酸性粒细胞增多症是一组异质性疾病,其特征是胸片上有肺部浸润,外周血中嗜酸性粒细胞水平升高。在这些疾病的患者中,过敏性支气管肺曲霉病 (ABPA) 或热带肺嗜酸性粒细胞增多症 (TPE) 的报告很常见。然而,ABPA 和 TPE 的同时发生并不常见。我们报告了一例有哮喘病史的年轻男性,被诊断为 ABPA 和 TPE。最初,患者对 ABPA 的治疗有部分反应,但持续的症状和嗜酸性粒细胞增多导致怀疑并随后诊断为 TPE。采用抗丝虫药和类固醇治疗后,患者的临床和血清学状况得到了满意的改善。这个病例强调了在具有重叠症状的患者中考虑多种诊断的重要性,并突出了在复杂肺部疾病中需要综合管理策略的必要性。

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本文引用的文献

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Allergic bronchopulmonary aspergillosis.变应性支气管肺曲霉病。
Indian J Med Res. 2020 Jun;151(6):529-549. doi: 10.4103/ijmr.IJMR_1187_19.
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Developments in the diagnosis and treatment of allergic bronchopulmonary aspergillosis.变应性支气管肺曲霉病的诊断与治疗进展
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Concurrent sensitization to Aspergillus Fumigatus in tropical pulmonary eosinophilia.
Monaldi Arch Chest Dis. 2016 Jun 22;81(1-2):736. doi: 10.4081/monaldi.2015.736.
8
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10
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