Nakamura Y, Hoshino M, Miyasaka T, Shimizu K, Yamashiro Y, Joon J, Hosaka K, Uchida K, Fukushima Y, Akasaka Y
Second Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Oct;34(10):1115-20.
A 64-year-old women presented with a dry cough. The common cold was diagnosed and she was given medication, but the symptom did not resolve. She came to our hospital, and multiple patchy shadows were seen on a chest X-ray film. Bronchoalveolar lavage fluid contained an abnormally high percentage of eosinophils. Microscopic examination of transbronchial lung biopsy specimens showed infiltration of eosinophils into the alveoli and alveolar septa. Chronic eosinophilic pneumonia was diagnosed. Analysis of bone marrow cells showed high percentages of mature eosinophilic cells, and blood serum had a high concentration of eosinophil cationic protein. An inhalation challenge test with methacholine revealed bronchial hypersensitivity and hyperresponsiveness. Prednisolone (30 mg/day) was given and the symptoms resolved. After steroid treatment, the patient was asymptomatic, although airway hyperresponsiveness remained. The concentration of eosinophil cationic protein in serum and the results of the methacholine inhalation test reflected the degree of chronic eosinophilic pneumonia, and the production of eosinophils in bone marrow was suppressed by steroid medication.
一名64岁女性出现干咳症状。诊断为普通感冒并给予药物治疗，但症状未缓解。她前来我院就诊，胸部X线片显示多个斑片状阴影。支气管肺泡灌洗液中嗜酸性粒细胞百分比异常升高。经支气管肺活检标本的显微镜检查显示嗜酸性粒细胞浸润至肺泡和肺泡间隔。诊断为慢性嗜酸性粒细胞性肺炎。骨髓细胞分析显示成熟嗜酸性细胞百分比高，血清中嗜酸性粒细胞阳离子蛋白浓度高。乙酰甲胆碱吸入激发试验显示支气管高敏性和高反应性。给予泼尼松龙（30毫克/天）治疗后症状缓解。类固醇治疗后，患者无症状，尽管气道高反应性仍然存在。血清中嗜酸性粒细胞阳离子蛋白浓度和乙酰甲胆碱吸入试验结果反映了慢性嗜酸性粒细胞性肺炎的程度，类固醇药物抑制了骨髓中嗜酸性粒细胞的生成。
