Kawayama T, Shigematsu H, Kawaguchi S, Kawahara M, Oizumi K
Department of Respiratory Disease, Sent Marry's Hospital, Fukuoka, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Dec;34(12):1401-5.
We encountered a family in which three of the five members (The parents and a daughter) had summer-type hypersensitivity pneumonitis that occurred in late summer. All three patients had a productive cough and shortness of breath. Chest roentgenograms of the mother and daughter (but not the father) showed diffuse small nodular shadows in both lung fields. Examination of bronchoalveolar lavage fluid from all three patients showed very high total cell counts, high percentages of T lymphocytes, and low ratios of CD4(+)-to-CD8+ cells. Microscopic examination of transbronchial biopsy specimens obtained from the daughter revealed infiltration of mononuclear cells with characteristic Masson bodies in alveolar septa, and granulomas in the interstitium. Both mother and daughter were positive for serum anti-Trichosporon cutaneum (serotype II) antibody, but the father, who was a current smoker was not. Thus, both mother and daughter were given the diagnosis of summer-type hypersensitivity pneumonitis, and in the father that diagnosis was strongly suspected.
我们遇到一个家庭，该家庭五名成员中有三名（父母和一个女儿）患有夏季型过敏性肺炎，发病于夏末。所有三名患者均有咳痰和气短症状。母亲和女儿（而非父亲）的胸部X线片显示双肺野弥漫性小结节阴影。对所有三名患者的支气管肺泡灌洗液检查显示，总细胞计数非常高，T淋巴细胞百分比高，CD4(+)与CD8+细胞比值低。对女儿进行经支气管活检标本的显微镜检查发现，肺泡间隔有单核细胞浸润并伴有特征性的马松小体，间质有肉芽肿。母亲和女儿的血清抗皮状毛孢子菌（血清II型）抗体呈阳性，但目前仍吸烟的父亲抗体呈阴性。因此，母亲和女儿均被诊断为夏季型过敏性肺炎，父亲则被高度怀疑患有该病。
