アレルギー性気管支炎 (喘息前段階) の臨床

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Some authers use allergic bronchitis interchangeably with "asthmatic bronchitis". But the definition of asthmatic bronchitis is variable depending on the person who defines it, so the term of this disease is vague in meaning and many writers dislike to use the term of asthmatic bronchitis, although there is not always the appropriate term about this disease. Such confusion, the authers believe, is based on the negligence to investigate cytogram and bacteria in the washed sputum. In auther' clinic the majority of patients with possibly lower respiratory tract diseases have been investigated into their sputa during more than a decade and culturing the washed sputa of these patients has also been added during late years. As the results comprehensive picture of allergic bronchitis became almost definitive. This time clinical pictures of allergic bronchitis based on authers' diagnostic criteria were presented. 1) This disease was divided into three clinical types: type I, frequent colds with productive cough, II, recurrent bronchitis and III, spasmodic cough. 2) The incidence of childhood asthma begins to nicrease about the age of 4 or 5, but this disease was the greatest during 1 to 3 years of age in type I and II and 5 years of age in type III. 3) Tye positive rate of reactions to various allergens showed lowest value in type I and intermediate value between control children and asthma in type II and III. 4) The number of cases which showed infectious signs and symptoms were found in 13 out of 88 cases. In only 6 of above cases, the appropriate antibiotic therapy provided dramatic relief and bacterial pathogens isolated in the washed sputum pneumococcus, staphylococcus aureus and hemophilus influenzae, which was particularly common. 5) Histaminopexic activity of the serum by the method of latex-histamine showed almost the same cummulative distribution curve as asthma. IgA, IgG and IgM were within normal limits. 6) Significant difference between allergic bronchitis and asthma was demonstrated in bronchial hypersensitivity measured with methacholine, i.e., the average decrease of F.E.V_1. showed intermediate value between asthma and control children. 7) During 3 years observation, about 25% developed asthma in an average of 7 months. Only 6.7% of type I developed asthma and 10 and 4 cases were subsequently reclassified type II and III respectively. About 50% of type II and 20% of type III developed asthma. 8) Cases with marked to moderate eosinophilia in the sputum develops asthma significantly in comparison with slight oesinophilia and similar result was obtained in type II and III in comparison with type I. 9) Cases with positive skin reactions to allergens develop asthma significantly in comparison with those of negative skin reaction. 1O) The authers treated 88 cases with nonspecific, symptomatic and specific hyposensitization therapies. A marked diffelence existed between narmally treated groups of allergic bronchitis, in tendency to develop asthma, in favor of the therapeutic effect of specific hyposensitization more than 2 months.
日本アレルギー学会の論文
1969-04-30

アレルギー性気管支炎 (喘息前段階) の臨床

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