同时诊断出过敏性支气管肺性阿斯伯吉洛症和Mycobacterium avium复杂肺病
Naoki Takasaka1, Kentaro Chida2, Takeo Ishikawa2
1Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan Hospital, Komae, Tokyo, Japan ntakasaka@jikei.ac.jp.
过敏性支气管肺性阿斯伯吉洛症 (ABPA) 和Mycobacterium avium复杂肺病 (MAC-LD) 可以同时发生. 在患有MAC-LD的患者中,伊特拉科纳单一治疗有效治疗ABPA,避免使用皮质类固醇.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 菌类学 菌类学是指菌类学.
背景情况:
- 支气管切开症是过敏支气管肺性阿斯伯吉洛症 (ABPA) 和Mycobacterium avium复杂肺病 (MAC-LD) 的常见危险因素.
- 同时的ABPA和MAC-LD存在诊断和治疗方面的挑战.
研究的目的:
- 在患有喘的患者中报告同时发生的ABPA和MAC-LD病例.
- 在MAC-LD的背景下,评估伊特拉科纳单疗对ABPA的疗效.
主要方法:
- 诊断是基于胸部CT检测结果 (心球节点,粘膜损伤) 和支气管镜检查.
- 患者最初接受了伊特拉科纳单一治疗的ABPA治疗.
- MAC治疗从伊特拉科纳单一疗法调整为组合疗法.
主要成果:
- 通过支气管镜检查证实了ABPA和MAC-LD的同时诊断.
- 单独治疗伊特拉科纳导致ABPA症状的显著临床改善,并允许避免系统性皮质类固醇.
- 通过组合治疗 (克拉里米辛,里法皮辛,乙胺醇) 实现了MAC唾液培养的转化.
- 通过重新启动伊特拉科纳来管理ABPA复发,并持续避免38个月的皮质类固醇.
结论:
- 伊特拉可纳单疗可以作为ABPA的可行的初始治疗方法,特别是在患有MAC-LD等慢性感染的患者中.
- 这种方法可能有助于避免在管理ABPA时使用全身皮质类固醇.
- 组合疗法对于实现MAC唾液转化至关重要.
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