过敏性支气管肺性阿斯伯吉洛症的非典型表现
Evelien Van Gogh1, Abraham Van Poppel1
1Pulmonology, University Hospital of Antwerp, Antwerp, BEL.
Cureus
|December 26, 2025
概括
过敏性支气管肺性阿斯伯吉洛症 (ABPA) 即使没有先前的肺部疾病,也可能异常表现为肺缩和肺部溢液. 早期诊断和用抗真菌药物和类固醇治疗导致完全康复.
科学领域:
- 肺部病理学 肺部病理学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 过敏性支气管肺性阿斯伯吉洛症 (ABPA) 是一种对Aspergillus fumigatus的免疫过敏症.
- ABPA通常影响喘或囊性纤维化患者.
- 罕见的ABPA呈现包括叶叶腺和胸腔溢液,模仿恶性瘤.
研究的目的:
- 在没有先前肺部疾病的患者中报告ABPA病例,表现为叶状腺脱氧和肺部溢液.
- 突出诊断挑战和在不寻常的演示中考虑ABPA的重要性.
主要方法:
- 一个57岁的男人咳和呼吸障碍病例报告.
- 诊断工作包括成像 (脱膜,排泄,淋巴腺病),支气管检查 (粘液塞),组织病理学,真菌培养和实验室测试 (eosinophilia,IgE,沉物).
主要成果:
- 支气管镜检查显示左上叶支气管完全被粘液塞堵塞.
- 组织病理学和培养证实了Aspergillus fumigatus感染.
- 实验室检测结果与ABPA一致,包括明显的乙酸性爱素,升高的IgE和阳性Aspergillus fumigatus沉物.
结论:
- 这种病例表明ABPA的不常见表现,包括叶片缩和多发性溢液.
- 考虑ABPA在无法解释或eosinophilic多流的差异诊断中至关重要.
- 口服普得尼索隆和伊特拉科纳的治疗导致了完全的临床和放射性康复.
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