Kawakami R, Kikuchi K, Kobayashi J, Shibuya Y, Hagiwara S, Saku N, Hironaka M, Fujii T, Chiba Y
Department of Pulmonary Medicine, Jichi Medical School, Tochigi, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Dec;34(12):1420-6.
In May 1995, a 52-year-old man complaining of fever and dyspnea was admitted to a hospital. Based on clinical and radiographic findings, hypersensitivity pneumonitis was suspected. Steroid pulse therapy was unsuccessful, and he was then transferred to our hospital. A chest X-ray film showed bilateral ground-glass shadows and a high-resolution CT scan showed cystic air spaces. The number of CD4-positive lymphocytes in peripheral blood was very low. A test for anti-human immunodeficiency virus antibody was positive and Pneumocystic carinii was found in bronchoalveolar lavage fluid. The acquired immunodeficiency syndrome and Pneumocystis carinii pneumonia were diagnosed. In this patient, the level of serum KL-6, a new marker of interstitial pneumonitis, was very high, and KL-6 was expressed on type II pneumocytes. The level of serum KL-6 may be useful as a marker of the activity of Pneumocystis carinii pneumonia.
1995年5月，一名主诉发热和呼吸困难的52岁男性入住一家医院。根据临床和影像学检查结果，怀疑为过敏性肺炎。类固醇冲击治疗未成功，随后他被转至我院。胸部X线片显示双侧磨玻璃影，高分辨率CT扫描显示囊状气腔。外周血中CD4阳性淋巴细胞数量非常低。抗人类免疫缺陷病毒抗体检测呈阳性，支气管肺泡灌洗液中发现卡氏肺孢子虫。诊断为获得性免疫缺陷综合征和卡氏肺孢子虫肺炎。在该患者中，新型间质性肺炎标志物血清KL-6水平非常高，且KL-6在Ⅱ型肺泡上皮细胞上表达。血清KL-6水平可能作为卡氏肺孢子虫肺炎活动的标志物。
