Inhalation provocation tests in chronic bird fancier's lung
Inhalation provocation tests in chronic bird fancier's lung
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DOI：
10.1378/chest.118.5.1382
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发表时间：
2000-11-01
期刊：
影响因子：
9.6
通讯作者：
Yoshizawa, Y
中科院分区：
文献类型：
--
作者：
Ohtani, Y;Kojima, K;Yoshizawa, Y
背景：慢性鸟类爱好者肺（BFL）汽车分为两种类型。一组患者发展为慢性疾病，伴有波动性急性发作，包括低热、轻度劳力性呼吸困难和咳嗽（波动性慢性BFL;以前称为复发性和复发性慢性BFL）。另一组患者无急性发作史（隐匿性慢性BFL）。慢性BFL的诊断是困难的，因为慢性BFL的发病可能是潜伏的，在疾病过程的早期阶段很少有症状。研究目的：为了尝试更精确地诊断这些患者的状况，使用鸟滴提取物进行吸入激发试验。设计：回顾性图表回顾。设置：日本东京医科和牙科大学医院。患者：11例慢性BFL患者（6例波动性慢性BFL和5例隐匿性慢性BFL）和6例对照组（4例无症状的鸟业主和2例特发性肺纤维化患者）进行了评估。测量和结果：使用鸟类下降提取物的吸入激发试验进行。通过吸入激发，所有BFL患者均被评价为阳性或可能阳性，而对照受试者被评价为阴性。外周白细胞增多，肺泡动脉氧压差增加，体温升高，呼吸道症状，包括咳嗽和呼吸困难的发展，更频繁地观察到慢性BFL患者比对照组。所有的BFL患者的BALF液中的中性粒细胞增加吸入challense.Conclusions：我们验证了慢性BFL，包括波动和隐匿BFL的诊断吸入挑战的效用。我们还证明，吸入激发后BAL液中的嗜中性粒细胞可以添加到慢性BFL的诊断标准中。
Background: Patients with chronic bird fancier's lung (BFL) cars be classified into two types. One group of patients develops chronic disease with fluctuating acute episodes, including low-grade fever, mild exertional dyspnea, and cough (fluctuating chronic BFL; formerly termed recurrent and relapsing chronic BFL). The other group of patients shows no history of acute episodes (insidious chronic BFL). The diagnosis of chronic BFL is difficult, since the onset of chronic BFL may be insidious, with few if and symptoms during the early stages of the disease process.Study objective: To attempt to diagnose the conditions of these patients more precisely, inhalation provocation tests were conducted using avian dropping extracts.Design: Retrospective chart review.Setting: The Tokyo Medical and Dental University Hospital in Japan.Patients: Eleven patients with chronic BFL (6 with fluctuating chronic BFL and 5 with insidious chronic BFL) and 6 control subjects (4 asymptomatic bird owners and 2 idiopathic pulmonary fibrosis patients) were evaluated.Measurements and results: Inhalation provocation tests using avian dropping extracts were conducted. All BFL patients were evaluated as positive or probable by inhalation challenge, whereas control subjects were-evaluated as negative. A peripheral leukocytosis, an increase of alveolar-arterial oxygen pressure difference, an increase of body temperature, and the development of respiratory symptoms including cough and dyspnea were more frequently observed in chronic BFL patients than in control subjects. All the BFL patients had an increase in neutrophils in BAL fluids following inhalation challenge.Conclusions: We validated the utility of inhalation challenge for the diagnosis of chronic BFL, including fluctuating and insidious BFL. We also demonstrated that neutrophilia in BAL fluids following inhalation challenge could be added to the diagnostic criteria for chronic BFL.