persistent pulmonary eosinophilic infiltrates
Introduction
Introduction to persistent pulmonary eosinophilic infiltration Prolonged pulmonary eosinophilic infiltration, also known as chronic eosinophilic pneumonia (chroniceosinophilic pneumonia), was first described by Carrington in 1969. The course of disease and X-ray findings are often prolonged, often more than one month, and the symptoms are more simple than PIE. To be heavy. basic knowledge The proportion of sickness: 0.004% - 0.009% Susceptible people: no specific population Mode of infection: non-infectious Complications: urticaria, respiratory failure, cough, hemoptysis, biliary ascariasis, hepatitis
Cause
Causes of persistent pulmonary eosinophilic infiltration
Parasitic infections (25%):
The etiology is similar to that of simple pulmonary eosinophilic infiltration. Some people think that it is a type of Luvrex syndrome. Among the parasites, hookworms and aphids are the most common, and nitrofurantoin is more common in drugs.
Allergic constitution (25%):
Other causes include coccidioidomycosis, brucellosis, etc. Many patients have allergies, but the true cause is unknown. A disease caused by Coccidioidomycetes, often manifested as an acute benign asymptomatic or self-limiting primary respiratory infection; occasionally spread, in the skin, subcutaneous tissue, lymph nodes, bones, The liver, kidney, meninges, brain or other tissues form focal lesions. Also known as Sanhua Gold or Valley Hot.
Pathology (35%):
There are dense eosinophils and macrophage infiltration in the interstitial and alveolar, accompanied by a small amount of lymphocytes and plasma cells. In addition, type II epithelial cell hyperplasia, alveolar protein exudation, fibroblast proliferation and septal collagen Sinking, eosinophils can also produce pyrogens, leading to frequent fever in such patients.
Prevention
Prolonged pulmonary eosinophilic infiltration prevention
Among the parasites, hookworms and mites are the most common. Therefore, in daily life, we should pay attention to our own food hygiene, bathe regularly, wash hands after urination, and pay attention to the management of faeces in rural areas. Eat spoiled vegetables and fruits, and do not eat uncooked meat.
Complication
Complications of persistent pulmonary eosinophilic infiltration Complications urticaria respiratory failure cough hemoptysis cholelithiasis hepatitis
Because of hookworms, there may be dermatitis, heterophilic disease, acne caused by mites, biliary ascariasis, dermatitis due to nitrofurantoin, neutropenia, hepatitis and so on.
Symptom
Symptoms of persistent pulmonary eosinophilic infiltration Common symptoms Cough with wheezing weight loss, weak wheezing, night sweats, low heat, night sweats
The ratio of male to female is 1:2, and the age is 20-50 years old. Half of the patients have allergies and the symptoms are different. They can only have chest X-ray abnormalities, but also can cause respiratory failure. The course of disease is about 1-8. Months, common symptoms are cough, fever, shortness of breath, weight loss, night sweats, fatigue, etc., a small number of patients may have hemoptysis, more than half of the patients may have wheezing on physical examination, and can hear fine wet rales.
Examine
Examination of persistent pulmonary eosinophilic infiltration
Typical X-ray findings often have diagnostic value, including three variations:
1 The oozing shadows unrelated to the lobes or segments are mainly distributed on the outside of both lungs and are progressive;
2 after the use of adrenocortical hormone, the exudate is quickly absorbed;
3 Repeated exudation with clinical symptoms.
Pulmonary function tests often showed restrictive ventilatory dysfunction with diffuse disorder and hypoxemia. Peripheral blood eosinophils ranged from 10% to 40%, and erythrocyte sedimentation rate increased significantly to 100 mm/h. Bronchoalveolar lavage fluid The proportion of eosinophils can be as high as 40% or more, and less than 1% in normal times, all of the above changes can be resolved after treatment.
Diagnosis
Diagnosis and differentiation of persistent pulmonary eosinophilic infiltration
Diagnosis often relies on typical medical history and X-ray findings. The disease should be differentiated from tuberculosis, Hodgkin's disease, etc. If there is doubt about the diagnosis, lung biopsy or bronchoalveolar lavage should be sought, and sometimes corticosteroids can be used for diagnosis. Sexual treatment.
The disease should be differentiated from tuberculosis and Hodgkin's disease.
