Cobos Barroso N, Canals Cadafalch J, Liñan Cortés S, Evangelista Masip A, Isturiz G, Barquet Esteve N
Allergol Immunopathol (Madr). 1980 Nov-Dec;8(6):637-42.
A case of hypersensitivity pneumonitis due to pigeon-dropping antigens is reported in a 9 year old girl, and compared with other seven previous reports in children. The insidious nature of this disease, as well as the importance of detailed environmental information in children with unexplained respiratory disease are emphasized. In this case, lung function tests showed a classic restrictive ventilatory defect, and a serious obstructive ventilatory defect evidenced in the narrowing of the smaller airways, and a reduction in the forced expiratory flow at small lung volumes. Hypersensitivity pneumonitis is a lung disease that results from sensitization by inhalation of a variety of organic dusts. Patients usually have circulating antibodies against the etiologic agents. Most patients with this disease also have sensitized T-cells to these agents. Long-term exposure can lead to irreversible lung disease. The histopathologic features are chronic interstitial and alveolar inflammation frequently accompanied by a granulomatous response. The most common symptomatic features are fever, chills and dyspnea 4 to 8 hours after exposure. Antibody activity to antigens is detected in the serum of both symptomatic and asymptomatic breeder's lung. Cellular hypersensitivity to antigens is demonstrated "in vitro" with peripheral lymphocyte populations in almost all symptomatic patients.
本文报告了一名9岁女孩因鸽粪抗原导致的过敏性肺炎病例，并与之前报道的其他7例儿童病例进行了比较。强调了这种疾病的隐匿性，以及详细环境信息对于患有不明原因呼吸道疾病儿童的重要性。该病例中，肺功能测试显示典型的限制性通气功能障碍，以及因小气道狭窄和小肺容积时用力呼气流量降低而证明的严重阻塞性通气功能障碍。过敏性肺炎是一种因吸入多种有机粉尘致敏而引起的肺部疾病。患者通常具有针对病原体的循环抗体。大多数患有这种疾病的患者对这些病原体也有致敏的T细胞。长期接触可导致不可逆的肺部疾病。组织病理学特征为慢性间质和肺泡炎症，常伴有肉芽肿反应。最常见的症状是接触后4至8小时出现发热、寒战和呼吸困难。在有症状和无症状的饲鸽者肺血清中均检测到对抗原的抗体活性。几乎所有有症状患者的外周淋巴细胞群体均在“体外”证明了对抗原的细胞超敏反应。
