[变应性肉芽肿性血管炎伴脑梗死、心肌心包炎及嗜酸性粒细胞性肺炎所致急性呼吸衰竭]

[Allergic granulomatous angiitis associated with cerebral infarction, myo-pericarditis and acute respiratory failure due to eosinophilic pneumonia].

作者信息

Aoshima M, Doi M, Usui Y, Tada H, Chonabayashi N, Matsusako M, Watanabe H, Doi O, Uekusa T, Saiki S

机构信息

Division of Respirology, St. Luke's International Hospital, Tokyo, Japan.

出版信息

Nihon Kokyuki Gakkai Zasshi. 1998 Nov;36(11):978-83.

PMID:9916484

Abstract

We encountered a 23-year-old woman with allergic granulomatous angiitis (AGA) associated with cerebral infarction, myo-pericarditis, and acute respiratory failure due to extended eosinophilic pneumonia. She underwent emergency treatment at our hospital because of right hemiparesis and impaired consciousness. AGA was suspected because the patient had a history of bronchial asthma accompanied by pulmonary infiltrations with eosinophilia, and presented with diffuse pulmonary infiltrates, pericardial effusion, diffuse hypokinesis of myocardium, cerebral infarction and marked peripheral eosinophlia. Pulmonary eosinophilia was confirmed by examination of broncho-alveolar lavage fluid. Myocardial tissue biopsy specimens revealed fibrous granulation indicative of myocarditis. The patient responded well to corticosteroid therapy.

摘要

我们遇到一名23岁女性，患有过敏性肉芽肿性血管炎（AGA），伴有脑梗死、心肌心包炎以及因嗜酸性粒细胞增多性肺炎扩展导致的急性呼吸衰竭。由于右侧偏瘫和意识障碍，她在我院接受了紧急治疗。该患者有支气管哮喘病史并伴有嗜酸性粒细胞增多性肺部浸润，出现弥漫性肺部浸润、心包积液、心肌弥漫性运动减弱、脑梗死以及明显的外周嗜酸性粒细胞增多，因此怀疑为AGA。通过支气管肺泡灌洗检查确诊为肺部嗜酸性粒细胞增多。心肌组织活检标本显示有提示心肌炎的纤维性肉芽组织。该患者对皮质类固醇治疗反应良好。