Takayama K, Yadohisa O, Furuno T, Hashimoto S, Nakanishi Y, Abe M, Komune S, Hara N
Research Institute for Diseases of the Chest, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am J Med Sci. 1995 May;309(5):282-4. doi: 10.1097/00000441-199530950-00008.
It has been reported that various organs are involved in idiopathic hypereosinophilic syndrome. Frequently, the heart, lung, skin, and nervous system are involved. Involvement of the middle ear, however, has not yet been reported. In this article, the authors describe the first case of hypereosinophilic syndrome involving the lung and middle ear. A 39-year-old woman had a 4-month history of low grade fever, non-productive cough, and a feeling of fullness and hearing loss in both ears. Peripheral blood cell count showed eosinophilia. Bilateral tympanic cavities were obstructed with granulation tissue, and she was diagnosed as obliterative otitis media. The granulation tissue consisted of foamy histiocytes and eosinophils. Chest X-ray film and computed tomography showed patchy infiltrative shadow in the lung. Histologic examination of the open lung biopsied specimen showed alveolar spaces infiltrated by eosinophils. After treatment with 30 mg oral prednisolone daily, there was a rapid improvement in her clinical condition. Based on the clinical course and the histologic findings of this case, obliterative otitis media may be caused by eosinophilic infiltration and eosinophilic pneumonia.
据报道，特发性嗜酸性粒细胞增多综合征累及多个器官。常见受累器官为心脏、肺、皮肤和神经系统。然而，中耳受累尚未见报道。在本文中，作者描述了首例累及肺和中耳的嗜酸性粒细胞增多综合征病例。一名39岁女性有4个月的低热、干咳病史，双耳有胀满感和听力下降。外周血细胞计数显示嗜酸性粒细胞增多。双侧鼓室被肉芽组织阻塞，她被诊断为闭塞性中耳炎。肉芽组织由泡沫状组织细胞和嗜酸性粒细胞组成。胸部X线片和计算机断层扫描显示肺部有斑片状浸润影。开放性肺活检标本的组织学检查显示肺泡腔有嗜酸性粒细胞浸润。每日口服30mg泼尼松龙治疗后，她的临床状况迅速改善。基于该病例的临床病程和组织学表现，闭塞性中耳炎可能由嗜酸性粒细胞浸润和嗜酸性粒细胞性肺炎引起。
