MINOCYCLINE-INDUCED CELL-MEDIATED HYPERSENSITIVITY PNEUMONITIS

被引：61

作者：

GUILLON, JM ^{[1
]}

JOLY, P ^{[1
]}

AUTRAN, B ^{[1
]}

DENIS, M ^{[1
]}

AKOUN, G ^{[1
]}

DEBRE, P ^{[1
]}

MAYAUD, C ^{[1
]}

机构：

[1] HOP LA PITIE SALPETRIERE, IMMUNOL CELLULAIRE LAB, F-75013 PARIS, FRANCE

来源：

ANNALS OF INTERNAL MEDICINE | 1992年 / 117卷 / 06期

关键词：

ALVEOLITIS; EXTRINSIC ALLERGIC; MINOCYCLINE; SUPPRESSOR CELLS; LYMPHOCYTES-T; CYTOTOXIC; DRUG HYPERSENSITIVITY;

D O I：

10.7326/0003-4819-117-6-476

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: To identify the cause of a hypersensitivity pneumonitis and to determine its pathogenesis. Design: Case study. Setting: Intensive care unit of a referral hospital. Patient: A 51-year-old man with chronic bronchitis who developed a hypersensitivity pneumonitis within 1 month after exposure to minocycline, amoxicillin, and erythromycin. Intervention: Sequential bronchoalveolar lavages after reexposure to minocycline and amoxicillin. Measurements: Immunologic analysis of the phenotype and function of alveolar lymphocytes. Results: Reexposure to minocycline but not to amoxicillin was followed by an interstitial pneumonitis. Sequential bronchoalveolar lavages showed a transient rise of eosinophils and neutrophils and a persistent alveolar lymphocytosis. Alveolar lymphocytes consisted predominantly of CD8+ but also CD4+ cells. Two CD8+ lymphocyte subsets were identified: CD8+ D44+ cytotoxic T cells that increased rapidly after the drug was resumed and CD8+ CD57+ suppressor T cells that predominated 11 days after the drug's withdrawal. In-vitro assays showed the presence of a lymphocyte-mediated specific cytotoxicity against minocycline-bearing alveolar macrophages. Conclusion: These results support the hypothesis of a central role of T lymphocytes in the pathogenesis of drug-related hypersensitivity pneumonitis.

引用

页码：476 / 481

页数：6

共 27 条

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