Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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The Characteristics of Eosinophilc Lung Diseases Cause by Toxocara Canis Larval Infestation

개회충 유충 감염에서 발생되는 호산구성 폐질환의 특성

  • Kim, Yu Jin (Department of Internal Medicine Gachon University, Gil Medical Center) ;
  • Kyung, Sun Young (Department of Internal Medicine Gachon University, Gil Medical Center) ;
  • An, Chang Hyeok (Department of Internal Medicine Gachon University, Gil Medical Center) ;
  • Lim, Young Hee (Department of Internal Medicine Gachon University, Gil Medical Center) ;
  • Park, Jung Woong (Department of Internal Medicine Gachon University, Gil Medical Center) ;
  • Jeong, Seong Hwan (Department of Internal Medicine Gachon University, Gil Medical Center) ;
  • Lee, Sang Pyo (Department of Internal Medicine Gachon University, Gil Medical Center) ;
  • Choi, Dong Chull (Department of Internal Medicine Sungkyunkwan University) ;
  • Jeong, Young Bae (Department of Parasitology, Cheju National University) ;
  • Kang, Shin Yong (Department of Parasitology, Chung Ang University)
  • 김유진 (가천의과학대학교 길병원 내과) ;
  • 경선영 (가천의과학대학교 길병원 내과) ;
  • 안창혁 (가천의과학대학교 길병원 내과) ;
  • 임영희 (가천의과학대학교 길병원 내과) ;
  • 박정웅 (가천의과학대학교 길병원 내과) ;
  • 정성환 (가천의과학대학교 길병원 내과) ;
  • 이상표 (가천의과학대학교 길병원 내과) ;
  • 최동철 (성균관대학교 삼성서울병원 내과) ;
  • 정영배 (제주대학교 기생충학교실) ;
  • 강신영 (중앙대학교 기생충학교실)
  • Received : 2006.11.29
  • Accepted : 2007.01.02
  • Published : 2007.01.30
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Abstract

Background: Toxocariasis is a common cause of eosinophilia and eosinophilic lung disease in Korea. We analyzed the characteristics of eosinophilic lung disease in toxocariasis. Method: One hundred and forty one patients with eosinophilia caused by a toxocara larval infection were evaluated from September 1, 2001 through March 30, 2006. The plain chest x-ray, chest CT(computed tomography), and bronchoalveolar larvage(BAL) were examined. A diagnosis of toxocariasis was made by ELISA using that secretory-excretory antigen from the T. canis larvae. Results: Toxocarial eosinophilic lung diseases was diagnosed in 32 out of 141 patients. Ground glass attenuation was the main feature on the CT scans in 23 out of 141 patients (71.9%). Thirteen patients (40.6%) had a random in zonal distribution on CT. Pleural effusion was observed in 9 patients (28.1%). Twenty eight patients (87.5%) complained of respiratory symptoms. Eleven patients (34.4%) had gastrointestinal symptoms and 12 patients (37.5%) had liver infiltration. Conclusions: The most common findings of the chest CT in patients with toxocariasis was a randomly distributed ground grass attenuation. A toxocara infection should be considered in a differential diagnosis of patients who exhibit pulmonary infiltration with eosinophilia in Korea.

연구배경: 개흡충증은 한국에서 호산구증다증과 호산구성 폐질환을 일으키는 흔한 원인의 하나이다. 우리는 개흡충증에 의한 호산구성 폐질환의 특장을 분석하였다. 방 법: 2001년 9월 1일부터 2006년 3월 30일까지 개회충 2기유충에 의한 호산구증다증으로 진단 받은 141명의 환자들을 대상으로 하였다. 본 연구를 위해 단순 흉부 방사선 촬영. 흉부 컴퓨터단층촬영, 기관지내시경, 기관지폐포세척술과 각종 혈액학적 검사를 시행하였다. 개회충증의 진단은 개회충 2기유충의 순수 분비배설 항원을 사용하였다. 결 과: 141명의 환자 중 32명이 개회충에 의한 호산구성 폐질환으로 진단되었다. 젖빛유리양상이 컴퓨터단층촬영에서 지배적으로 23/32명(71.9%)이었다. 13/32명(40.6%)은 무작위적 구역적 분포를 보였다. 흉 수액이 9/32명(28.1%)에서 관찰되었다. 28/32명(87.5%)이 호흡기 증상을 호소하였다. 11/32명(34.4%)은 호흡기 증상과 소화기 증상을 동시에 호소하였다. 12/32명(37.5%)에서 간에 국소의 저음영의 침윤을 보였다. 결 론: 개회충에 의한 호산구성폐질환의 임상적, 방사선적 특성은 다발성의 결절성 또는 경화성의 젖빛유리음영이 양폐 상하엽에 무작위적 분포를 하는 것이다. 앞으로 우리나라에서 호산구 증다증과 폐침윤을 보이는 성인에서 감별진단을 위해 개회충증의 가능성을 고려해야 할 것으로 판단된다.

Keywords

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