Doeker B, Hussein A, Trowitzsch E
Abt. Kinderkardiologie und Pulmonologie, Vestische Kinderklinik Datteln, Universität Witten-Herdecke.
Klin Padiatr. 1998 Sep-Oct;210(5):340-4. doi: 10.1055/s-2008-1043899.
Interstitial lung diseases, with or without pulmonary hypertension and epidermolysis bullosa are rare in infancy. Pathogenetic correlations between these disease are not known and their coincidence has not been reported, yet. We report on a seven weeks old boy of consanguine parents with typical skin efflorescences of epidermolysis bullosa, tachydyspnoea and cyanosis. Echocardiography and cardiac catheterisation revealed pulmonary hypertension, which persisted under therapy with oxygen and nifedipin. Lung biopsy showed interstitial and peribronchiolar increased lymphocytes and lymphfollicels, a mild intraalveolar desquamation and a media hypertrophy of the arteries. A combined therapy of prednisone and nifedipine normalised the pulmonary hypertension and the oxygen saturation. The activity of the epidermolysis bullosa showed no correlation with the interstitial lung disease or with the therapy. A connection between both diseases is discussed.
间质性肺疾病,无论是否合并肺动脉高压以及大疱性表皮松解症,在婴儿期均较为罕见。目前尚不清楚这些疾病之间的发病机制关联,且它们的并存情况此前也未见报道。我们报告了一名7周大的男婴,其父母为近亲,该男婴患有典型的大疱性表皮松解症皮肤疹、呼吸急促和发绀。超声心动图和心导管检查显示存在肺动脉高压,在接受氧气和硝苯地平治疗后仍持续存在。肺活检显示间质和细支气管周围淋巴细胞及淋巴滤泡增多,轻度肺泡内脱屑以及动脉中层肥厚。泼尼松和硝苯地平联合治疗使肺动脉高压和血氧饱和度恢复正常。大疱性表皮松解症的活动情况与间质性肺疾病或治疗无相关性。本文讨论了这两种疾病之间的联系。