以咯血为首发症状的急性嗜酸性粒细胞性肺炎  

Acute eosinophilic pneumonia presented with hemoptysis as the first manifestation

作　　者：代雨萌 黄林洁[1] 江山平[1] 林小玲[1] 伍俊妍[2] 马丽萍[3] 王林[4] 沈君[5] 戴冽[6] 唐恬恬 Dai Yumeng;Huang Linjie;Jiang Shanping;Lin Xiaoling;Wu Junyan;Ma Liping;Wang Lin;Shen Jun;Dai Lie;Tang Tiantian(Departmment of Pulmonary and Critical Care Medicine,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Pharmacy,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Hematology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Pathology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Radiology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Rheumatology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院呼吸与危重症医学科,广州510120 [2]中山大学孙逸仙纪念医院药学部,广州510120 [3]中山大学孙逸仙纪念医院血液内科,广州510120 [4]中山大学孙逸仙纪念医院病理科,广州510120 [5]中山大学孙逸仙纪念医院放射科影像专科,广州510120 [6]中山大学孙逸仙纪念医院放射科风湿免疫科,广州510120

出　　处：《中华结核和呼吸杂志》2024年第11期1097-1101,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：国家自然科学基金(82071804,82271813)。

摘　　要：本文报道1例38岁男性患者,以"咯血10 d"入院,入院前1周吸烟量增加。胸部CT示双肺多发渗出。支气管肺泡灌洗液嗜酸性粒细胞比例升高,确诊"急性嗜酸性粒细胞性肺炎",经糖皮质激素治疗后肺部渗出完全吸收。综合PUBMED上234例AEP相关的英文病例报道,本病例是迄今已报道的急性嗜酸性粒细胞肺炎患者中以咯血为首发及唯一症状的病例,提示了急性嗜酸粒细胞性肺炎患者临床表现的多样性。提醒临床医生对急性烟草暴露后出现不能以其他疾病解释的咯血、肺部磨玻璃改变的患者,鉴别诊断应注意排查急性嗜酸粒细胞肺炎。We reported a case of 38-year-old man who was admitted with a 10-day history of hemoptysis.He had reported a significant increasing in tobacco consumption in the week prior to admission.Chest computed tomographic(CT)scans showed multiple ground-glass opacities in bilateral lung fields.The percentage of eosinophils in the bronchoalveolar lavage fluid was over 25%.Based on the patient's imaging findings and the predominant eosinophilia in the bronchoalveolar lavage,a diagnosis of acute eosinophilic pneumonia was made.Systemic corticosteroid therapy was initiated.Repeated CT scan showed the opacities were completely resolved afterwards.Compared with the previous case reports published in Pubmed,which included 234 patients with AEP,the present case described hemoptysis as the only manifestation in an AEP patient,indicating the diversity of clinical manifestations of AEP.Clinicians should consider the probability of AEP in patients with hemoptysis and pulmonary ground-glass opacities after acute tobacco exposure if the disease cannot be explained by other causes.

关 键 词：肺嗜酸粒细胞增多 肺炎 咯血 磨玻璃影 

分 类 号：R563.1[医药卫生—呼吸系统]