Uchida K, Sekiguchi S, Doi Y
Department of Respiratory Medicine, Inada-Noborito Hospital, Kanagawa, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Aug;31(8):1040-4.
A 18-year-old woman presented to our hospital complaining of an acute onset of progressive dyspnea with nonproductive cough and high fever. The patient was in her usual good health until the previous day, when she started to develop symptoms 8 hours after taking aspirin for a headache. The chest roentgenogram revealed Kerley's lines (A and B), perivascular cuffing and hilar haze with bilateral pleural effusions. Body temperature was 38 degrees C and PaO2 was 48 torr. Infectious diseases and extrinsic allergic alveolitis were excluded. The lymphocyte stimulating test was negative for aspirin. Acute eosinophilic pneumonia was strongly suggested by bronchoalveolar lavage showing a marked increase in eosinophils without peripheral eosinophilia. By the seventh hospital day all clinical and radiographic signs were improved without steroid therapy. Most cases of acute eosinophilic pneumonia reported previously showed diffuse infiltrative shadows on the chest roentgenogram. The present case had interesting radiographic findings which suggested interstitial pulmonary edema.
一名18岁女性因急性起病的进行性呼吸困难、干咳和高热前来我院就诊。该患者此前一直身体健康,直到前一天,她因头痛服用阿司匹林8小时后开始出现症状。胸部X线片显示有克氏线(A线和B线)、血管周围套袖征、肺门模糊以及双侧胸腔积液。体温为38摄氏度,动脉血氧分压为48托。排除了传染病和外源性过敏性肺泡炎。淋巴细胞刺激试验对阿司匹林呈阴性。支气管肺泡灌洗显示嗜酸性粒细胞显著增加而外周血嗜酸性粒细胞无增多,强烈提示急性嗜酸性粒细胞性肺炎。到住院第七天时,所有临床和影像学表现未经类固醇治疗即已改善。先前报道的大多数急性嗜酸性粒细胞性肺炎病例胸部X线片显示弥漫性浸润阴影。本病例有有趣的影像学表现,提示间质性肺水肿。