摘要
海納氏症候群是指對牛奶蛋白過敏合併肺血鐵質沉積症的病人，而肺血鐵質沉積症是指在肺部有不正常的血鐵質(hemosiderin)沉積在肺部的巨噬細胞，在x光上有肺部侵潤並且因血鐵質沉積而造成缺鐵性貧血。我們報告一個兩歲六個月的女童，七個多月大時被發現有缺鐵性貧血，後來因有反覆性咳血的現象而來到醫院求治。做肺泡支氣管抽吸檢查，發現抽吸液呈鐵鏽色，染色檢查發現有血鐵質沉積在巨噬細胞(hemosiderin laden macrophage)內，進一步對女童做牛奶蛋白的皮膚針刺、皮膚貼布和口服激發試驗皆呈陽性反應，這些發現確定病童對牛奶蛋白過敏同時合併有肺血鐵質沉積症，所以符合海納氏症候群的診斷。目前病童在正確避免牛奶相關飲食與單純只用吸入性類固醇治療情況下，並無再度發生咳血情形。
並列摘要
Heiner's syndrome consists of pulmonary hemosiderosis associated with allergic reactions after ingesting cow's milk. Pulmonary hemosiderosis is characterized by the accumulation of iron within the pulmonary macrophages as hemosiderin combined with iron-deficiency anemia. We present a two and a half year old girl who had shown signs of iron-deficiency anemia since she was 7 months old. She was sent to our hospital for evaluation of recurrent hemoptysis. Rusty color aspiration was noted via bronchoscopic lavage. In addition, iron staining revealed numerous hemosidersin-laden macrophages, which were compatible with pulmonary hemosiderosis. The result of the skin prick test, skin patchy test, and oral provocation test were positive for cow's milk. Pulmonary hemosiderosis associated with an allergic reaction to cow's milk was confirmed. The diagnosis of Heiner's syndrome was established. All cow's milk and milk products were withheld and oral steroids were given. Her clinical condition rapidly improved. She is currently using inhaled steroid therapy, and we found no hemoptysis during the latest follow-up examination.
延伸閱讀
- 姜義祺、徐世達（2003）。海納氏症候群。臺灣兒童過敏氣喘及免疫學會學會通訊，4(4)，4-5。https://doi.org/10.7025/HEJ.200312.0004
- 健康世界資料室（2005）。霍納氏症候群。健康世界，(240)，36-36。https://doi.org/10.6454/HW.200512.0036
- 徐世達（2016）。海納氏症候群(Heiner's syndrome)。台灣氣喘衛教學會會刊，(41)，20-21。https://doi.org/10.6669/TAAE.2016.41.20
- 葉大川（1987）。瑞特氏症候群。當代醫學，(164)，491-496。https://doi.org/10.29941/MT.198706.0016
- 陳逸光、林昭安、黃富源、林雲南（1975）。Reye's Syndrome。Acta Paediatrica Sinica，16(3)，158-165。https://www.airitilibrary.com/Article/Detail?DocID=00016578-197509-16-3-158-165-a