ACUTE EOSINOPHILIC PNEUMONIA AS A REVERSIBLE CAUSE OF NONINFECTIOUS RESPIRATORY-FAILURE
ACUTE EOSINOPHILIC PNEUMONIA AS A REVERSIBLE CAUSE OF NONINFECTIOUS RESPIRATORY-FAILURE
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DOI：
10.1056/nejm198908313210903
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发表时间：
1989-08-31
影响因子：
158.5
通讯作者：
DAVIS, WB
中科院分区：
文献类型：
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作者：
ALLEN, JN;PACHT, ER;DAVIS, WB
虽然慢性嗜酸性肺炎是一种众所周知的疾病，但急性嗜酸性肺炎并不是很典型。我们描述了4例急性嗜酸性肺炎患者的临床特征、支气管肺泡灌洗结果和随访研究。患者表现为急性发热性疾病、严重低氧血症(动脉血氧分压60 mm Hg)、弥漫性肺浸润性病变、嗜酸性粒细胞增多(平均+-)。扫描电子显微镜，42.+-.4.8%)，无感染和既往特应性疾病。在红霉素和皮质类固醇治疗后，病情迅速缓解。这些患者接受了口服泼尼松的剂量，剂量在10天至12周内逐渐减少，自停止使用类固醇以来，没有一人复发。在至少五个月的随访期后，临床评估、胸片和肺功能测试均未显示急性嗜酸性肺炎所致的残留异常。后续的支气管肺泡灌洗显示。所有患者中有1%的嗜酸性粒细胞。我们认为我们描述的是一种急性形式的嗜酸性肺病，与以前描述的综合征不同。它可以通过支气管肺泡灌洗来诊断，并且似乎对皮质类固醇的治疗有反应。
Although chronic eosinophilic pneumonia is a well-known disorder, acute eosinophilic pneumonia has not been as well characterized. We describe the clinical features, results of bronchoalveolar lavage, and follow-up studies of four patients with acute eosinophilic pneumonia. The patients presented with an acute febrile illness, severe hypoxemia (partial pressure of arterial oxygen < 60 mm Hg), diffuse pulmonary infiltrates, an increased number of eosinophils (mean .+-. SEM, 42.+-.4.8 percent) in bronchoalveolar-lavage fluid, and an absence of infection and previous atopic illness. The illness resolved rapidly after treatment with erythromycin and corticosteroids. The patients received doses of oral prednisone that were tapered over 10 days to 12 weeks, and none have relapsed since the steroids were discontinued. After a minimum follow-up period of five months, clinical evaluation, chest radiography, and pulmonary-function tests have shown no residual abnormalities attributable to the acute eosinophilic pneumonia. Follow-up bronchoalveolar lavage has demonstrated .ltoreq. 1 percent eosinophils in all patients. We believe that we are describing an acute form of eosinophilic lung disease distinct from previously described syndromes. It can be diagnosed by bronchoalveolar lavage and seems to respond to treatment with corticosteroids.