Transient bronchoalveolar neutrophilia in a patient with atopic asthma
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概要
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経過中に気管支肺胞洗浄(BAL)液中に一過性の好中球増多が観察されたアトピー型喘息症例について,若干の臨床的観察を加えた｡症例は,64才の女性で,臨床症状,および血清IgE高値,ハウスダストに対するIgE抗体陽性などから,アトピー型喘息と診断された｡なお,経過観察し得た15ヵ月の間に2回の大発作が観察された｡1.第1回の大発作後,BAL液中好中球増多と換気機能の低下が観察された｡そして,このBAL液中好中球頻度は明らかな改善が見られた｡BAL液中の総細胞数および好中球の絶対数も徐々に減少傾向を示し,好中球頻度と同様,第2回目の大発作3ヵ月後には著明な減少が観察された｡同時にこの時期には,BAL液中リンパ球の増加も見られた｡しかし,BAL液中好酸球数は15ヵ月の経過観察中ほとんど変化は見られなかった｡Clinical course of one asthma patient (64 years old, female), who had an increased proportion of neutrophils in bronchoalveolar lavage (BAL) fluid, was observed in relation to the proportion of BAL cells and ventilatory function. The patient had large asthma attacks two times during her clinical course for 15 months observed. 1. Anincreased proportion of BAL neutrophils and suppression of ventilatory function were found after her first large asthma attacks. The increased proportion of BAL neutrophilscontinued for more than 5 months. A reduction in the proportion of BAL neutrophils was found 3 months after her second large asthma attack, accompanied by improvement of clinical symptoms and ventilatory function. The numbers of total cells and neutrophils in BAL fluid were also reduced. Transient increase in number of BAL lymphocytes was found 13 months after the first large attack when the number of BAL neutrophils was markedly decreased. The number of BAL eosinophils did not change during her clinical course.
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