全肺洗浄前後で血清KL-6, SP-AおよびSP-D値を測定し得た肺胞蛋白症の1例  [in Japanese] Serum KL-6, SP-A and SP-D Levels as Monitoring Markers in a Patient with Pulmonary Alveolar Proteinosis  [in Japanese]

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Abstract

近年, 血清KL-6, SP-A, SP-D値は間質性肺炎の活動性の有用な指標として報告されている。今回全肺洗浄前後のモニタリングに血清KL-6, SP-A, SP-D値を用いた肺胞蛋白症の1例を報告する。症例は労作時息切れで入院した67歳の女性で, 胸部X線写真上両中下肺野に非区域性の浸潤影が認められた。胸部CTでは非区域性に広がるスリガラス様陰影と小葉間隔壁の肥厚が見られ, peripheral clear zoneが認められた。気管支肺胞洗浄と経気管支肺生検により肺胞蛋白症と診断し, 全肺洗浄が施行された。全肺洗浄後, 症状, 血液ガス, 胸部X線写真の改善とともに血清KL-6値は減少したが, SP-A, SP-D値は一過性に上昇し, その後低下した。血清KL-6, SP-A, SP-D値は病勢と一致しており, 肺胞蛋白症において有用な活動性のマーカーになりうると考えられた。

Serum KL-6, SP-A and SP-D levels have been reported to be valuable indicators of the disease activity of interstitial pneumonia. We monitored there in a case of pulmonary alveolar proteinosis. A 67-year-old woman who presented with exertional dyspnea was found to have bilateral non-segmental reticular infiltration shadows in the middle and lower lung fields on her chest radiograph. Chest CT scan revealed diffuse ground glass opacities with thickening of the interlobular septum and a peripheral clear zone. Because pulmonary alveolar proteinosis was confirmed confirmed by bronchoalveolar lavage and transbronchial lung biopsy, total bilateral whole lung lavages were performed. The serum KL-6 level decreased after whole lung lavages and correlated with symptoms, opacities on the chest radiograph, and arterial blood gas measurements but the serum SP-A and SP-D level increased transiently after whole lung lavages. The serum KL-6, SP-A and SP-D levels may be useful monitoring markers for pulmonary alveolar proteinosis.

Journal

  • The Journal of the Japan Society for Respiratory Endoscopy

    The Journal of the Japan Society for Respiratory Endoscopy 22(7), 547-552, 2000

    The Japan Society for Respiratory Endoscopy

References:  20

Codes

  • NII Article ID (NAID)
    110002815230
  • NII NACSIS-CAT ID (NCID)
    AN00357687
  • Text Lang
    JPN
  • Article Type
    SHO
  • ISSN
    0287-2137
  • Data Source
    CJP  NII-ELS  J-STAGE 
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