Patterson D L, DeRemee R A, Hunt L W
Division of Allergic Diseases and Internal Medicine, Mayo Clinic Rochester, Minnesota.
Mayo Clin Proc. 1994 Aug;69(8):774-8. doi: 10.1016/s0025-6196(12)61098-2.
Progressive dyspnea that developed in a 52-year-old woman with a lifelong history of asthma did not respond to high-dose orally administered glucocorticoids. Initially, a diagnosis of allergic bronchopulmonary aspergillosis or hypersensitivity pneumonia was suggested as the cause of the worsening dyspnea. Pulmonary function tests demonstrated severe airway obstruction; substantial improvement was noted after bronchodilator therapy. Maximal inspiratory pressure was decreased, and the diffusing capacity of the lungs was abnormal. Computed tomography of the chest showed no parenchymal or mediastinal abnormalities. During a sniff test, fluoroscopy of her diaphragm disclosed paradoxical motion of both hemidiaphragms during inspiration, consistent with bilateral hemidiaphragmatic paralysis. Parsonage-Turner syndrome was diagnosed. The dose of glucocorticoids was tapered. Follow-up of the patient by telephone contact in March 1994 (9 months after her initial examination at our clinic) revealed that the dyspnea was still severe.
一名有终身哮喘病史的52岁女性出现进行性呼吸困难，对大剂量口服糖皮质激素治疗无反应。最初，考虑变应性支气管肺曲霉病或过敏性肺炎为呼吸困难加重的原因。肺功能检查显示严重气道阻塞；支气管扩张剂治疗后有显著改善。最大吸气压力降低，肺弥散功能异常。胸部计算机断层扫描未显示实质或纵隔异常。在嗅气试验期间，对其膈肌进行荧光透视检查发现双侧膈肌在吸气时出现矛盾运动，符合双侧膈肌麻痹。诊断为Parsonage-Turner综合征。糖皮质激素剂量逐渐减少。1994年3月（在我们诊所初次检查9个月后）通过电话联系对患者进行随访，发现呼吸困难仍然严重。
