一名患有慢性脂质性肺炎儿童的支气管肺泡灌洗细胞分析

Bronchoalveolar lavage cell analysis in a child with chronic lipid pneumonia.

作者信息

Midulla F, Strappini P M, Ascoli V, Villa M P, Indinnimeo L, Falasca C, Martella S, Ronchetti R

机构信息

IV Dept of Pediatrics, Institute of Pediatrics, University of Rome La Sapienza, Italy.

出版信息

Eur Respir J. 1998 Jan;11(1):239-42. doi: 10.1183/09031936.98.11010239.

DOI:10.1183/09031936.98.11010239

PMID:9543299

Abstract

In an asymptomatic 4 yr old child with radiographic evidence of parenchymal lung disease, bronchoalveolar lavage (BAL) yielded the diagnosis of chronic lipid pneumonia caused by chronic aspiration of mineral oil given as a laxative. BAL analysis showed a marked reduction in the total number of alveolar macrophages; almost 70% of these cells contained intracytoplasmic lipid vacuoles. It also disclosed lymphocytic (cytotoxic/suppressor) alveolitis. A high percentage of lymphocytes expressed antigen markers of activation (human leucocyte antigen (HLA)-DR), CD54 and CD25). BAL analysis 18 months after mineral oil intake revealed that lymphocytes bearing antigen markers of activation had markedly decreased whereas alveolar macrophages (normal and lipid-laden) had increased. A subsequent whole lung BAL was considered unnecessarily invasive in this otherwise healthy child.

摘要

在一名4岁无症状儿童中，胸部X线检查有实质性肺部疾病的证据，经支气管肺泡灌洗（BAL）诊断为慢性脂质性肺炎，病因是长期服用作为泻药的矿物油导致慢性误吸。BAL分析显示肺泡巨噬细胞总数显著减少；其中近70%的细胞含有胞浆内脂质空泡。分析还显示存在淋巴细胞性（细胞毒性/抑制性）肺泡炎。高比例的淋巴细胞表达活化抗原标志物（人类白细胞抗原（HLA）-DR）、CD54和CD25。摄入矿物油18个月后的BAL分析显示，携带活化抗原标志物的淋巴细胞显著减少，而肺泡巨噬细胞（正常及含脂质的）增多。对于这个原本健康的儿童，后续进行全肺BAL被认为具有不必要的侵入性。