混合型嗜酸性粒细胞性胃肠炎1例-现代医学

混合型嗜酸性粒细胞性胃肠炎1例

单位：1. 广州中医药大学第四临床医学院, 广东深圳 518033;
2. 深圳市中医院消化内科, 广东深圳 518033

分类号：R573.3

出版年·卷·期（页码）：2020·39·第八期（1046-1050）

摘要：

目的：探讨嗜酸性粒细胞性胃肠炎（eosinophilic gastroenteritis，EG）的临床特点、诊断、治疗方法，以提高临床上对该病的诊治。方法：对本院1例以“腹泻、腹痛”为主要表现的35岁女性患者进行诊断治疗及随访，并结合相关文献，探讨EG患者的临床表现、实验室检查、影像学检查、内窥镜表现的特点及治疗方法。结果：结合患者临床表现、血清学检查、影像学检查及内窥镜检查，最终诊断为EG，经口服醋酸泼尼松片抗炎、抑酸、保护胃肠黏膜、止泻等治疗约2周后症状缓解，复查外周血嗜酸性粒细胞（eosinophils，Eos）明显下降，好转出院，出院后随访4月，复查外周血Eos恢复正常，无腹泻、腹痛等症状复发。结论：EG患者临床表现、实验室检查、影像学检查和内窥镜检查表现多样，缺乏特异性，外周血、骨髓及腹水中的Eos升高对本病有提示意义，确诊需组织病理学结果，大部分患者经糖皮质激素治疗预后较好。

Objective: To explore the clinical characteristics, diagnosis and treatment methods of eosinophilic gastroenteritis(EG) in order to improve the clinical diagnosis and treatment rate of the disease.Methods: A 35-year-old female patient with diarrhea and abdominal pain as the main manifestation in our hospital was diagnosed, treated and followed up. And EG patient' characteristics of the clinical manifestations, laboratory examinations, imaging examinations, and endoscopic performance were discussed in combination with relevant literature.Results: Combined with the clinical manifestations, serological examination, imaging examination and endoscopic examination of the patient, the final diagnosis was EG. After oral prednisone acetate tablets used for anti-inflammatory, acid suppression, gastrointestinal mucosa protection, antidiarrhea and other treatments about 2 weeks, symptoms of the patient were relieved and the eosinophils (Eos) in peripheral blood decreased significantly after reexamination. He recovered and was discharged from hospital. He was followed up for 4 months after discharge. The Eos in peripheral blood returned to normal without recurrence of diarrhea and abdominal pain.Conclusion: The clinical manifestations, laboratory examinations, imaging examinations, and endoscopic performance of EG patients are diverse and lack specificity. The increase of Eos in peripheral blood, bone marrow, and ascites is suggestive of the disease. The diagnosis requires histopathological results. Most patients have a better prognosis after treatment with glucocorticoids.

参考文献：

[1] TALLEY N J,SHORTER R G,PHILLIPS S F,et al.Eosinophilic gastroenteritis:a clinicopathological study of patients with disease of the mucosa,muscle layer,and subserosal tissues[J].Gut,1990,31(1):54-58.
[2] OSHIMA T,SHAN J,OKUGAWA T,et al.Down-regulation of claudin-18 is associated with the proliferative and invasive potential of gastric cancer at the invasive front[J].PloS One,2013,8(9):e74757.
[3] ANTONELLA C,JONATHAN M S.Eosinophilic esophagitis and gastroenteritis[J].Current Allergy and Asthma Reports,2015,15(9):58.
[4] 郭锐芳,李宏亮,胡燕梅,等.嗜酸性粒细胞性胃肠炎254例分析[J].宁夏医科大学学报,2016,38(7):819-820.
[5] WONG G W,LIM K H,WAN W K,et al.Eosinophilic gastroenteritis:clinical profiles and treatment outcomes,a retrospective study of 18 adult patients in a Singapore Tertiary Hospital[J].Medical Journal of Malaysia,2015,70(4):232-237.
[6] Klein N C,Hargrove R L,Sleisenger M H,et al.Eosinophilic gastroenteritis[J].Medicine,1970,49(4):299-319.
[7] Kelly K J.Eosinophilic gastroenteritis[J].Journal of Pediatric Gastroenterology and Nutrition,2000,30(Suppl):S28-35.
[8] HUANG F C,KO S F,HUANG S C,et al.Eosinophilic gastroenteritis with perfotation mimicking intussusceptions[J].Journal of Pediatric Gastroenterology and Nutrition,2001,33(5):613-615.
[9] 向红雨,周中银.嗜酸性胃肠炎的研究进展[J].疑难病杂志,2018,17(7):753-756.
[10] 张力,邓艳伟,于淑靖,等.嗜酸性胃肠炎的CT表现及临床特征分析[J].影像诊断与介入放射学,2016,25(3):189-192.
[11] REED C,WOOSLEY J T,DELLON E S.Clinical characteristics,treatment outcomes,and resource utilization in children and adults with eosinophilic gastroenteritis[J].Digestive and Liver Disease,2015,47(3):197-201.
[12] UPPAL V,KREIGER P,KUTSCH E.Eosinophilic gastroenteritis and colitis:a comprehensive review[J].Clinical Reviews in Allergy Immunology,2016,50(2):175-188.
[13] ZUO L,SHANG L,ZHANG X,et al.Severe eosinophilic gastroenteritis[J].Gastrointestinal Endoscopy,2016,84(4):745-746.
[14] 丰艳,燕善军.嗜酸性粒细胞性胃肠炎的诊断及治疗[J].国际消化病杂志,2015,35(4):256-257.
[15] 赵翊迪,冯晓莹,宋青雅.嗜酸性粒细胞性胃肠炎的研究进展[J].临床荟萃,2017,32(8):733-736.

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