Extrinsic Allergic Alveolitis: A Case Report and the Literature Review_West China Medical Journal

Authors：

LIU Shaohua ,  YANG Xiaodong , WANG Yanting , HUANG Yanhua , LIU Zhengman

Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

YANG Xiaodong, Email: chongyang163@163.com

Keywords：

外源性過敏性肺泡炎; 變態反應

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目的　提高對外源性過敏性肺泡炎的認識。方法　回顧分析2011年10月報道1例外源性過敏性肺泡炎（過敏性肺炎）患者的診斷及治療經過，總結其臨床特征、診療要點及預后評價。結果　患者數次誤診后最終診斷為外源性過敏性肺泡炎，予脫離變應原及激素治療后痊愈，隨訪半年無復發。結論　該病臨床表現無特異性，需結合患者病史、臨床癥狀、血清學檢查、影像學表現，甚至肺泡灌洗液及肺活檢綜合判斷；脫離變應原為該病治療的最根本、最重要措施；對于病情嚴重患者，短期全身性使用糖皮質激素可縮短病程或改善癥狀。

Citation： LIU Shaohua,YANG Xiaodong,WANG Yanting,HUANG Yanhua,LIU Zhengman. Extrinsic Allergic Alveolitis: A Case Report and the Literature Review. West China Medical Journal, 2012, 27(4): 524-526. doi: Copy

1.	Martinez FJ, Keane MP. Update in diffuse parenchymal lung diseases 2005[J]. Am J Respir Crit Care Med, 2006, 173(10): 1066-1071.
2.	Solaymani-Dodaran M, West J, Smith C, et al. Extrinsic allergic alveolitis: incidence and mortality in the general population[J]. QJM, 2007, 100(4):233-237.
3.	Bogaert P, Tournoy KG, Naessens T, et al. Where asthma and hypersensitivity pneumonitis meet and differ: noneosinophilic severe asthma[J]. Am J Pathol, 2009, 174(1): 3-13.
4.	Bourke SJ, Dalphin JC, Boyd G, et al. Hypersensitivity pneumonitis: current concepts[J]. Euro Respir J Suppl, 2001, 18(Suppl 32): 81-92.
5.	Lacasse Y, Cormier Y. Hypersensitivity pneumonitis[J].Orphanet J Rare Dis, 2006, 1(1): 25.
6.	Ando M, Suga M, Kohrogi H. A new look at hypersensitivity pneumonitis[J]. Curr Opin Pulm Med, 1999, 5(5): 299-304.
7.	Wang P, Xu ZJ, Xu WB, et al. Clinical features and prognosis in 21 patients with extrinsic allergic alveolitis[J]. Chin Med Sci J, 2009, 24(4): 202-207.
8.	Hirschmann JV, Pipavath SN, Godwin JD. Hypersensitivity pneumonitis: a historical, clinical, and radiologic review[J]. Radio Graphics, 2009, 29(7): 1921-1938.
9.	江文云，林秉崇，黃果平. 外源性過敏性肺泡炎誤診肺結核 3 例 [J]. 中國防癆雜志, 2009, 31(5): 315-316.
10.	Silva CI, Churg A, Müller NL. Hypersensitivity pneumonitis: spectrum of high-resolution CT and pathologic findings[J]. AJR Am J Roentgenol, 2007, 188(2): 334-344.
11.	班承鈞，代華平，張曙，等. 外源性過敏性肺泡炎高分辨率CT特點及其診斷價值 [J]. 中華醫學雜志, 2010, 90(16): 1105-1108.
12.	Vourlekis JS, Schwarz MI, Cool CD, et al. Nonspecific interstitial pneumonitis as the sole histologic expression of hypersensitivity pneumonitis[J]. Am J Med, 2002, 112 (6): 490-493.
13.	Hanak V, Golbin JM, Ryu JH. Causes and presenting features in 85 consecutive patients with hypersensitivity pneumonitis[J]. Mayo Clin Proc, 2007, 82(7): 812-816.
14.	Lacasse Y, Selman M, Costabel U, et al. Clinical diagnosis of hypersensitivity pneumonitis[J]. Am J Respir Crit Care Med, 2003, 168(8): 952-958.
15.	Kokkarinen JI, Tukiainen HO, Terho EO. Effect of corticosteroid treatment on the recovery of pulmonary function in farmer’s lung[J]. Am Rev Respir Dis, 1992, 145(1): 3-5.

1. 　Martinez FJ, Keane MP. Update in diffuse parenchymal lung diseases 2005[J]. Am J Respir Crit Care Med, 2006, 173(10): 1066-1071.
2. 　Solaymani-Dodaran M, West J, Smith C, et al. Extrinsic allergic alveolitis: incidence and mortality in the general population[J]. QJM, 2007, 100(4):233-237.
3. 　Bogaert P, Tournoy KG, Naessens T, et al. Where asthma and hypersensitivity pneumonitis meet and differ: noneosinophilic severe asthma[J]. Am J Pathol, 2009, 174(1): 3-13.
4. 　Bourke SJ, Dalphin JC, Boyd G, et al. Hypersensitivity pneumonitis: current concepts[J]. Euro Respir J Suppl, 2001, 18(Suppl 32): 81-92.
5. 　Lacasse Y, Cormier Y. Hypersensitivity pneumonitis[J].Orphanet J Rare Dis, 2006, 1(1): 25.
6. 　Ando M, Suga M, Kohrogi H. A new look at hypersensitivity pneumonitis[J]. Curr Opin Pulm Med, 1999, 5(5): 299-304.
7. 　Wang P, Xu ZJ, Xu WB, et al. Clinical features and prognosis in 21 patients with extrinsic allergic alveolitis[J]. Chin Med Sci J, 2009, 24(4): 202-207.
8. 　Hirschmann JV, Pipavath SN, Godwin JD. Hypersensitivity pneumonitis: a historical, clinical, and radiologic review[J]. Radio Graphics, 2009, 29(7): 1921-1938.
9. 　江文云，林秉崇，黃果平. 外源性過敏性肺泡炎誤診肺結核 3 例 [J]. 中國防癆雜志, 2009, 31(5): 315-316.
10. 　Silva CI, Churg A, Müller NL. Hypersensitivity pneumonitis: spectrum of high-resolution CT and pathologic findings[J]. AJR Am J Roentgenol, 2007, 188(2): 334-344.
11. 　班承鈞，代華平，張曙，等. 外源性過敏性肺泡炎高分辨率CT特點及其診斷價值 [J]. 中華醫學雜志, 2010, 90(16): 1105-1108.
12. 　Vourlekis JS, Schwarz MI, Cool CD, et al. Nonspecific interstitial pneumonitis as the sole histologic expression of hypersensitivity pneumonitis[J]. Am J Med, 2002, 112 (6): 490-493.
13. 　Hanak V, Golbin JM, Ryu JH. Causes and presenting features in 85 consecutive patients with hypersensitivity pneumonitis[J]. Mayo Clin Proc, 2007, 82(7): 812-816.
14. 　Lacasse Y, Selman M, Costabel U, et al. Clinical diagnosis of hypersensitivity pneumonitis[J]. Am J Respir Crit Care Med, 2003, 168(8): 952-958.
15. 　Kokkarinen JI, Tukiainen HO, Terho EO. Effect of corticosteroid treatment on the recovery of pulmonary function in farmer’s lung[J]. Am Rev Respir Dis, 1992, 145(1): 3-5.

West China Medical Journal

Extrinsic Allergic Alveolitis: A Case Report and the Literature Review

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