HYPERSENSITIVITY PNEUMONITIS ASSOCIATED WITH HOME ULTRASONIC HUMIDIFIERS
HYPERSENSITIVITY PNEUMONITIS ASSOCIATED WITH HOME ULTRASONIC HUMIDIFIERS
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DOI：
10.1378/chest.107.3.711
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发表时间：
1995-03-01
期刊：
影响因子：
9.6
通讯作者：
CHIDA, K
中科院分区：
文献类型：
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作者：
SUDA, T;SATO, A;CHIDA, K
我们描述了5例过敏性肺炎（HP），这是有关使用家庭超声加湿器。所有患者的胸片上都有微小结节浸润，他们的肺活检标本显示肺泡炎伴或不伴上皮样细胞肉芽肿。对2名使用湿化器水的患者和3名使用湿化器的患者进行了挑战试验。所有受试者均表现出阳性反应。针对加湿器水提取物的沉淀抗体测试在接受测试的ah患者中显示出强烈的阳性反应。在所有情况下，顶头孢霉和白色念珠菌的沉淀素也存在，而嗜热放线菌的沉淀素没有检测到。虽然培养的水生长的各种真菌和细菌的有机体，嗜热放线菌无法检测到。这些结果表明，嗜热微生物可能不是与超声湿化器相关的HP的致病抗原。所有5例患者的支气管肺泡灌洗（BAL）淋巴细胞（主要是CD 4+淋巴细胞）均增加。辅助性T细胞（CD_4）/抑制性T细胞（CD_8）比值显著高于夏型HP，而低于养鸟者肺组织，提示BAL淋巴细胞的表型可能随HP类型而异。
We describe five patients with hypersensitivity pneumonitis (HP) that was related to using home ultrasonic humidifiers. All patients had micronodular infiltrates on their chest radiograph, and their lung biopsy specimens revealed alveolitis with or without epithelioid cell granulomas. Challenge tests were performed on two patients with the humidifier water and three patients using the humidifier. All patients tested exhibited a positive response. Tests for precipitating antibodies against an extract of the humidifier water gave strongly positive reactions in ah patients tested. Precipitins to Cephalosporium acremonium and Candida albicans were also present in all cases, whereas precipitins to thermophilic actinomycetes were not detected. Although cultures of the water grew a variety of fungal and bacterial organisms, thermophilic actinomycetes could not be detected. These findings suggest that thermophilic organisms may not be the causative antigens of HP associated with ultrasonic humidifiers. All five patients had an increase in the bronchoalveolar lavage (BAL) lymphocytes that were predominantly CD4+ lymphocytes. The T helper cell count (CD4) to suppressor T cell count (CD8) ratio was significantly higher than that observed in summer-type HP, and lower than that observed in bird fancier's lung, indicating that the phenotypes of the BAL lymphocytes may vary with the type of HP.