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患女,50岁,干部。以气短8月于1996年5月8日入院。8月前在家中使用灭害灵气雾剂时即感喉部不适,胸闷、气短。停用及脱离环境后症状减轻,再用又复加重。曾先后在外院校“肺炎,肺结核”治疗6月无效。其间用地塞米松5mg/d,3周后症状消失,胸片恢复正常。停用症状再发。查体:T36.6C,P80次/min,R20次/min,BP17/12kPa。一般情况好。无紫绀及呼吸困难,浅表淋巴结不大。胸廓对称呼吸动度一致,双肺下部可闻及中小水泡音。心腹及四肢等检查正常。实验室检查免疫球蛋白IgM3.26g/L(正常0.48～2.40g/L)纤支镜检示:支气管粘膜急性炎性改变。胸片显示:双肺中下野有片絮状密度增高影。CT提示:“肺结核、肺炎”。其它检查均正常。综合分析考虑诊断为外原性变态反应性肺泡炎。给予强的松10mg/次,3次/d,口服,症状很快缓解,胸片复查双肺病灶几乎消失。
Women, 50 years old, cadres. Shortness of breath in August on May 8, 1996 admission. 8 months ago at home when the use of anti-narcotic aerosol feeling throat discomfort, chest tightness, shortness of breath. Discontinued and out of the environment after the symptoms alleviate, and then re-added. Has worked in the outer school “pneumonia, tuberculosis” treatment in June invalid. During which dexamethasone 5mg / d, 3 weeks after the symptoms disappeared, chest X-ray returned to normal. Disable the recurrence of symptoms. Physical examination: T36.6C, P80 times / min, R20 times / min, BP17 / 12kPa. Generally good. No cyanosis and dyspnea, superficial lymph nodes is not large. Thoracic symmetry Breathing consistent, lower lungs can be heard and small blisters sound. Confidants and limbs and other tests normal. Laboratory examination of immunoglobulin IgM3.26g / L (normal 0.48 ~ 2.40g / L) bronchoscopy: bronchial mucosal acute inflammatory changes. Chest radiograph showed: middle and lower lungs have a piece of floc density increased shadow. CT tip: “Tuberculosis, pneumonia.” Other tests are normal. Comprehensive analysis to consider the diagnosis of exogenous alveolar alveolar inflammation. Given prednisone 10mg / time, 3 times / d, oral, the symptoms quickly eased, chest X-ray examination of lung lesions almost disappeared.