CHRONIC EOSINOPHILIC PNEUMONIA
CHRONIC EOSINOPHILIC PNEUMONIA
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DOI：
10.1136/thx.35.8.570
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发表时间：
1980-01-01
期刊：
影响因子：
10
通讯作者：
SEED, WA
中科院分区：
文献类型：
--
作者：
FOX, B;SEED, WA
本文描述了病因不明的[3]患者伴嗜酸性粒细胞性肺炎的临床调查和肺活检。患者病程6 ~ 20周，主要表现为咳嗽、呼吸困难、全身不适，2例持续发热。所有患者均有嗜酸性粒细胞增多，胸片显示广泛的双侧阴影；2例有特征性外周分布。1例患者自发恢复，另外2例对类固醇有反应，发热在12小时内消失，放射学在14天内清除。急性期肺功能检查显示2例体积受限和/或气体传递缺陷。缓解后3例均出现小气道功能异常。在急性疾病期间行肺活检，采用组织学和透射电镜检查，2例采用免疫荧光检查。肺泡内和间质嗜酸性粒细胞性肺炎伴闭塞性细支气管炎、微肉芽肿和血管炎。电镜显示大量嗜酸性粒细胞，大量脱粒细胞和巨噬细胞伴被吞噬的嗜酸性粒细胞颗粒和胞浆内包涵体。1例支气管壁及间质可见IgM、IgG、IgA。没有IgE或补体存在。嗜酸性粒细胞颗粒明显导致组织损伤和发热；这方面的机制和对类固醇治疗的反应提出了建议。
Patients [3] with eosinophilic pneumonia of unknown etiology investigated clinically and by lung biopsy are described. The illnesses lasted between 6 and 20 wk and consisted of cough, dyspnea, malaise and in 2 cases prolonged pyrexia. All had blood eosinophilia and chest radiographs showing widespread bilateral shadowing; in 2 cases this had a characteristic peripheral distribution. One patient recovered spontaneously and the other 2 responded to steroids, with disappearance of pyrexia within 12 h and radiological clearing within 14 days. Lung function tests during the acute illness showed volume restriction and/or gas transfer defects in 2 cases. After remission all 3 showed abnormalities of small airways function. Lung biopsies performed during the acute illness were examined histologically and by transmission electron microscopy, and in 2 cases by immunofluorescence. There was intra-alveolar and interstitial eosinophilic pneumonia with bronchiolitis obliterans, microgranulomata and a vasculitis. EM showed numerous eosinophils, many degranulated and macrophages with phagocytosed eosinophilic granules and intracytoplasmic inclusions. In 1 case IgM, IgG and IgA were demonstrated in the bronchial walls and interstitium. No IgE or complement was present. Eosinophil granules are apparently responsible for the tissue damage and fever; mechanisms for this and for the response to steroid therapy are suggested.