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[通过支气管肺泡灌洗流体淋巴细胞刺激试验诊断柴苓汤诱发肺炎的病例]

[A case of Sairei-to-induced pneumonitis diagnosed by lymphocyte stimulation test of bronchoalveolar lavage fluid].

作者信息

Maeno T, Ubukata M, Maeno Y, Suga T, Motegi M, Takayanagi N, Takahashi M, Nagai R

机构信息

Department of Internal Medicine, Tano General Hospital, Fujioka, Japan.

出版信息

Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Dec;35(12):1347-51.

PMID:9567079
Abstract

A 51-year-old woman was admitted with fever, cough and dyspnea. She had been taking Sairei-to, a traditional Chinese medicine, for 2 months. On admission, chest X-ray revealed a ground-glass appearance in the lung fields bilaterally and serum LDH was elevated. A differential cell count of the bronchoalveolar lavage fluid (BALF) showed that lymphocytes were increased, with a decreased ratio of CD4/CD8 cells. A lymphocyte stimulation test (LST) for Sairei-to using the lymphocytes in BALF was a positive, although a test of peripheral blood was negative. Sairei-to-induced pneumonitis was diagnosed based on the clinical course, laboratory findings, BALF cell analysis and LST of BALF. Only 4 cases of pneumonitis due to Sairei-to have been reported. This case suggests that LST of BALF is useful for diagnosing drug-induced pneumonitis.

摘要

一名51岁女性因发热、咳嗽和呼吸困难入院。她服用中药柴苓汤已2个月。入院时,胸部X线显示双肺野呈磨玻璃样改变,血清乳酸脱氢酶升高。支气管肺泡灌洗液(BALF)的细胞分类计数显示淋巴细胞增多,CD4/CD8细胞比值降低。用BALF中的淋巴细胞进行的柴苓汤淋巴细胞刺激试验(LST)呈阳性,而外周血试验为阴性。根据临床病程、实验室检查结果、BALF细胞分析和BALF的LST,诊断为柴苓汤诱发的肺炎。仅报告了4例柴苓汤引起的肺炎病例。该病例表明,BALF的LST对诊断药物性肺炎有用。

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