Summer-type hypersensitivity pneumonitis. A unique disease in Japan.
Summer-type hypersensitivity pneumonitis. A unique disease in Japan.
复制标题
夏季型过敏性肺炎。
作者：
T. Kawai;T. Kawai;M. Tamura;M. Tamura;M. Murao;M. Murao
在日本发现了一种独特的过敏性肺炎，其临床症状在夏季出现，在中秋节自发消退。这种疾病被命名为夏季型过敏性肺炎，并发现在日本最流行的形式。该病具有以下特征：1）夏季发病; 2）多年来在随后季节反复发作; 3）家族性发生; 4）无职业关系; 5）回家激发试验阳性; 6）咳嗽、呼吸困难和张张热为临床三联症; 7）胸部X线片上弥漫性结节影; 8）白细胞增多伴中性粒细胞增多; 9）% VC中度降低，Dco和PaO 2显著降低; 10）有症状时皮肤对PPD的反应性为阴性; 11）活检标本的肺部病变显示上皮样细胞肉芽肿，无中心坏死（63.3%），加上肺泡炎和/或肺炎; 12）将患者与家庭环境隔离可减轻症状; 13）皮质类固醇有效; 14）季节性的大气微生物污染是推测的，但致病抗原尚未确定。
A unique form of hypersensitivity pneumonitis in which clinical symptoms appear in the summer and subside spontaneously in the mid-autumn was found in Japan. This disease was named summer-type hypersensitivity pneumonitis and was found the most prevalent form in Japan. This disease has the following characteristic features: 1) initiation in the summer; 2) repeated episodes during subsequent seasons for many years; 3) familial occurrence; 4) no occupational relationship; 5) positive returning-home provocation test; 6) cough, dyspnea and remittent fever as a clinical triad; 7) diffuse nodular shadows on chest x-ray film; 8) leukocytosis with neutrophilia; 9) moderately decreased % VC and markedly decreased Dco and PaO2; 10) skin reactivity to PPD is negative while symptomatic; 11) pulmonary lesions of biopsied specimens show epithelioid cell granulomas without central necrosis (63.3 percent), plus alveolitis and/or pneumonitis; 12) isolation of patients from their home environment diminishes symptoms; 13) corticosteroid is effective; 14) seasonal atmospheric microbiological pollution is speculated upon, but the offending antigen is not defined yet.