Koizumi T, Yamazaki Y, Kaneki T, Hirai K, Kubo K, Kobayashi T, Sekiguchi M, Yoshimura K
First Department of Medicine, Shinshu University, Matsumoto, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Aug;35(8):921-5.
We encountered two patients with summer-type hypersensitivity pneumonitis that developed in Nagano Prefecture. Patient 1 was a 61-year-old man who had worked in warm and humid environments as painter. He was referred to our hospital because of fever, coughing and exertional dyspnea. Respiratory symptoms developed during work but were gone within in few weeks. Patient 2 was a 50-year-old housewife who was admitted to our hospital because of persistent coughing and a low-grade fever. In both patients, chest roentgenograms and computed tomograms showed bilateral, small, nodular and reticular shadows. Examination of a specimen obtained from patient 2 by transbronchial lung biopsy revealed alveolitis. In both patients, bronchoalveolar lavage fluid had low CD4/8 ratios, but in patient 1 the lymphocyte fraction was high and in patient 2 the neutrophil fraction was high. A steroid drug was given to patient 1 because of the patients symptoms and prolonged abnormal roentgenographic findings. Patient 2 reacted positively on a provocation test when returned to her house. Serum from both patients contained antibodies to Trichosporon mucoides and T. asahii. We know of no previous reports of summer-type hypersensitivity pneumonitis that developed in Nagano prefecture.
我们遇到了两名在长野县患上夏季型过敏性肺炎的患者。患者1是一名61岁男性，曾作为油漆工在温暖潮湿的环境中工作。他因发热、咳嗽和劳力性呼吸困难被转诊至我院。呼吸道症状在工作期间出现，但在几周内消失。患者2是一名50岁家庭主妇，因持续咳嗽和低热入住我院。两名患者的胸部X光片和计算机断层扫描均显示双侧小的结节状和网状阴影。对患者2经支气管肺活检获取的标本进行检查发现肺泡炎。两名患者的支气管肺泡灌洗液中CD4/8比值均较低，但患者1的淋巴细胞比例较高，患者2的中性粒细胞比例较高。由于患者的症状和长期异常的影像学表现，给患者1使用了类固醇药物。患者2回到家中后激发试验呈阳性反应。两名患者的血清中均含有抗粘液样毛孢子菌和浅白隐球菌的抗体。我们此前未听说过有在长野县发生夏季型过敏性肺炎的报道。
