Ayame Nana, Tanabe Yuki, Motojima Mai, Tachi Ryosuke, Makino Fumihiko, Oh Shiaki, Sasaki Shinichi, Takahashi Kazuhisa
Department of Respiratory Medicine Juntendo University Graduate School of Medicine Tokyo Japan.
Department of Respiratory Medicine Juntendo University Urayasu Hospital Chiba Japan.
Respirol Case Rep. 2024 Sep 17;12(9):e70021. doi: 10.1002/rcr2.70021. eCollection 2024 Sep.
Few reports have described the treatment of eosinophilic pneumonia (EP) complicated by refractory pneumothorax. A 62-year-old man with a medical history of ulcerative colitis who was undergoing maintenance treatment presented with fever, cough, and diffuse bilateral consolidation on chest radiography. Laboratory findings showed peripheral eosinophilia, and he was hospitalized with a diagnosis of drug-induced EP and started on corticosteroid therapy. During the course, he developed refractory pneumothorax, and it was difficult to control the air leakage. As it was necessary to control the eosinophilic inflammation and air leakage, mepolizumab, a humanized anti-interleukin-5 monoclonal antibody, and an endobronchial Watanabe spigot (EWS), were introduced. After EWS insertion, the leakage of the refractory pneumothorax disappeared. The patient continued to have no recurrence of EP or pneumothorax after the removal of the EWS. The combination of mepolizumab and an EWS may be effective in cases of EP complicated by refractory pneumothorax.
很少有报告描述过嗜酸性粒细胞性肺炎（EP）合并难治性气胸的治疗情况。一名有溃疡性结肠炎病史且正在接受维持治疗的62岁男性，出现发热、咳嗽，胸部X线检查显示双侧弥漫性实变。实验室检查发现外周血嗜酸性粒细胞增多，他因药物性EP诊断入院并开始接受糖皮质激素治疗。在此过程中，他出现了难治性气胸，且漏气难以控制。由于需要控制嗜酸性粒细胞炎症和漏气，遂使用了人源化抗白细胞介素-5单克隆抗体美泊利单抗以及支气管内渡边套管（EWS）。插入EWS后，难治性气胸的漏气消失。拔除EWS后，患者的EP和气胸均未再复发。美泊利单抗和EWS联合使用可能对EP合并难治性气胸的病例有效。
