Li Zhaolin, Hong Luna, Li Yuewei, Lin Xiaoling, Chen Ming, Bu Shiyi, Xu Shuwan, Zeng Qiaojun, Huang Yijiao, Bian Lijuan, Zheng Jianming, Gao Boying, Liu Guirong, He Wenman, Song Xueming, Ye Fengzhan, Huang Linjie, Jiang Shanping, Shi Jianting, Tang Tiantian
Department of Pulmonary and Critical Care Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Department of Cardiology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China.
SAGE Open Med Case Rep. 2024 Jun 16;12:2050313X241261152. doi: 10.1177/2050313X241261152. eCollection 2024.
Allergic respiratory diseases can increase serum carcinoembryonic antigen levels. We report three cases experiencing allergic symptoms that proved refractory to inhaled corticosteroids but exhibited a positive response to long-term treatment with oral corticosteroids. This response was characterized by a synchronous alteration in serum eosinophil counts and carcinoembryonic antigen levels. Immunofluorescence assays indicated localized carcinoembryonic antigen production within eosinophils. In addition, we conducted a systematic review of patients exhibiting similar characteristics on PubMed. After comprehensively reviewing this unique pathophysiological condition, we herein introduced a novel term "Allergic hyper-carcinoembryonic antigen syndrome," defined by the following criteria: (1) recurrent asthmatic attacks; (2) eosinophilia or pulmonary eosinophilic infiltrations accompanied by elevated serum carcinoembryonic antigen levels; (3) pulmonary lesions determined by imaging or biopsy; (4) exclusion of malignancy and infections; and (5) responsive to systemic corticosteroids. Allergic hyper-carcinoembryonic antigen syndrome suggests systemic corticosteroids should be introduced early when managing allergic patients with both eosinophilia and elevated serum carcinoembryonic antigen levels.
过敏性呼吸道疾病可使血清癌胚抗原水平升高。我们报告了3例出现过敏症状的病例，这些症状对吸入性糖皮质激素治疗无效，但对口服糖皮质激素长期治疗表现出阳性反应。这种反应的特征是血清嗜酸性粒细胞计数和癌胚抗原水平同步改变。免疫荧光分析表明嗜酸性粒细胞内存在局部癌胚抗原产生。此外，我们在PubMed上对具有相似特征的患者进行了系统评价。在全面回顾这种独特的病理生理状况后，我们在此引入了一个新术语“过敏性高癌胚抗原综合征”，其定义如下标准：（1）反复发作的哮喘发作；（2）嗜酸性粒细胞增多或肺部嗜酸性粒细胞浸润伴血清癌胚抗原水平升高；（3）通过影像学或活检确定的肺部病变；（4）排除恶性肿瘤和感染；（5）对全身糖皮质激素有反应。过敏性高癌胚抗原综合征提示，在治疗同时伴有嗜酸性粒细胞增多和血清癌胚抗原水平升高的过敏患者时，应尽早使用全身糖皮质激素。
