CHRONIC EOSINOPHILIC PNEUMONIA
CHRONIC EOSINOPHILIC PNEUMONIA
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DOI：
10.1056/nejm196904102801501
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发表时间：
1969-01-01
影响因子：
158.5
通讯作者：
GAENSLER, EA
中科院分区：
文献类型：
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作者：
CARRINGT.CB;ADDINGTO.WW;GAENSLER, EA
9名妇女出现了一种不寻常的独特综合征，包括慢性和最终危及生命的疾病，伴有高烧、盗汗、体重减轻和严重呼吸困难。结核病是大多数病例的初步诊断，但患者的病情在化疗中恶化。哮喘发生的第一次发病的疾病在6名患者，而3既没有哮喘也没有血嗜酸性粒细胞增多症。X线片显示特征性的、快速进行性的、致密的肺浸润，以一种特殊的外周模式排列，最好描述为肺水肿阴影的“摄影底片”。慢性嗜酸性粒细胞性肺炎被确认为一致的病理模式的肺活检。皮质类固醇治疗引起完全临床恢复和清除的X线片在几天内。随着过早减少或治疗的遗漏，症状复发，浸润再次出现在相同的位置。长期随访观察表明，虽然这一过程可能进展为纤维化，但预后一般良好。
Nine women presented an unusual and distinctive syndrome consisting of a chronic and ultimately life-threatening illness with high fever, night sweats, weight loss and severe dyspnea. Tuberculosis was the initial diagnosis in most cases, but the patients' condition deteriorated on chemotherapy. Asthma occurred for the first time with the onset of the illness in six patients, whereas three had neither asthma nor blood eosinophilia. The roentgenograms showed characteristic, rapidly progressive, dense pneumonic infiltrates arranged in a peculiar peripheral pattern best described as a "photographic negative" of the shadows seen in pulmonary edema. Chronic eosinophilic pneumonia was recognized from the consistent pathological pattern of the lung biopsies. Corticosteroid therapy caused complete clinical recovery and clearing of the roentgenograms within a few days. With premature reduction or omission of therapy symptoms recurred, and the infiltrates reappeared precisely in the same locations. Long-term follow-up observation suggests that, although this process may progress to fibrosis, the prognosis is generally good.