吸入烟曲霉后发生的外源性过敏性肺泡炎。IV型免疫发病机制的证据。

Extrinsic allergic alveolitis after Aspergillus fumigatus inhalation. Evidence of a type IV immunologic pathogenesis.

作者信息

Yocum M W, Saltzman A R, Strong D M, Donaldson J C, Ward G W, Walsh F M, Cobb O M, Elliott R C

出版信息

Am J Med. 1976 Dec;61(6):939-45. doi: 10.1016/0002-9343(76)90419-8.

Abstract

Three weeks after a massive inhalation of mold present on infected oats, a farmer's wife had extrinsic allergic alveolitis. Aspergillus fumigatus was cultured from the moldy oats and from deep bronchial washings obtained at fiberoptic bronchoscopy. Spores and hyphae characteristic of Aspergillus species were demonstrated within granulomas in the pulmonary tissue obtained by transbrochial biopsy. Serum precipitins, delayed (48 hour) cutaneous hypersensitivity and in vitro lymphocyte transformation to A. fumigatus were demonstrated. The findings in this case suggest that a type IV immunologic response and subsequent (lymphocyte-mediated) tissue inflammation may underlie the pathogenesis of this and other forms of hypersensitivity pneumonitis.

摘要

在大量吸入受感染燕麦上存在的霉菌三周后，一位农民的妻子患上了外源性过敏性肺泡炎。从发霉的燕麦以及纤维支气管镜检查时获取的深部支气管灌洗物中培养出了烟曲霉。经支气管活检获取的肺组织肉芽肿内发现了曲霉菌属特有的孢子和菌丝。检测到血清沉淀素、延迟（48小时）皮肤超敏反应以及体外淋巴细胞对烟曲霉的转化。该病例的研究结果表明，IV型免疫反应及随后（淋巴细胞介导的）组织炎症可能是这种及其他形式的过敏性肺炎发病机制的基础。