기관지폐포 세척액 내 호산구가 증가된 박리성 간질성 폐렴 1예

• Published in: The Korean journal of medicine pp. 335 - 339
• Main Authors: 최유희, 김태현, 강래형, 김형진, 장진호, 신동훈, 전두수
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.09.2015
• Subjects: 내과학
• ISSN: 1738-9364; 2289-0769
• DOI: 10.3904/kjm.2015.89.3.335

박리성 간질성 폐렴의 기관지폐포 세척액 소견은 잘 알려져 있지 않지만 특징적으로 호산구가 증가한 증례들이 보고되고 있어 감별 진단에 주의를 기울여야 한다. 저자들은 기관지폐포 세척액의 호산구가 37%로 증가되어 만성 호산구성폐렴으로 오인하였다가 수술적 조직 진단을 통해 박리성 간질성 폐렴으로 확진했던 증례를 경험하였기에 보고하는 바이다. Here, we present a case of desquamative interstitial pneumonia (DIP) that was initially misdiagnosed as chronic eosinophilic pneumonia due to an increased number of eosinophils in the bronchoalveolar lavage fluid (BALF). A 56-year-old male smoker presented with a productive cough that had been present for 1 month. High-resolution computed tomography (HRCT) revealed multifocal patchy ground-glass and reticular opacities in the subpleural area. BALF analysis revealed an elevated level of eosinophils (37%). Thus, the patient was initially diagnosed with chronic eosinophilic pneumonia and was administered prednisolone (0.5 mg/kg/day). However, his symptoms and the diffuse infiltrative shadows on HRCT did not improve after 2 months of treatment, and a video-assisted thoracoscopic lung biopsy led to the diagnosis of DIP. Prednisolone (1 mg/kg/day) was administered again, and the patient’s symptoms improved. At 1 year after the end of treatment, the patient remained symptom-free. KCI Citation Count: 0