Barak N, Hart J, Sitrin M D
University of Chicago, Chicago, Illinois, USA.
J Clin Gastroenterol. 2001 Aug;33(2):157-8. doi: 10.1097/00004836-200108000-00014.
Eosinophilic gastroenteritis is a rare disorder of unknown etiology. We describe a case of a 63-year-old woman with chronic diarrhea and eosinophilia. Small bowel biopsy revealed eosinophils in large clusters in the lamina propria with focal infiltration of the epithelium. The patient's diarrhea and eosinophilia started shortly after enalapril was prescribed. When the patient was instructed to stop taking that drug, her diarrhea promptly ceased, and the blood eosinophil level returned to normal. This is the first reported case of eosinophilic gastroenteritis associated with an angiotensin-converting enzyme inhibitor. Eosinophilic gastroenteritis should be entertained in the differential diagnosis of patients taking angiotensin-converting enzyme inhibitors who develop diarrhea or other gastrointestinal symptoms.
嗜酸性粒细胞性胃肠炎是一种病因不明的罕见疾病。我们描述了一例63岁患有慢性腹泻和嗜酸性粒细胞增多症的女性病例。小肠活检显示固有层有大量嗜酸性粒细胞聚集，上皮有局灶性浸润。患者的腹泻和嗜酸性粒细胞增多症在服用依那普利后不久出现。当患者被指示停用该药物时，腹泻立即停止，血液嗜酸性粒细胞水平恢复正常。这是首例报道的与血管紧张素转换酶抑制剂相关的嗜酸性粒细胞性胃肠炎病例。对于服用血管紧张素转换酶抑制剂后出现腹泻或其他胃肠道症状的患者，鉴别诊断时应考虑嗜酸性粒细胞性胃肠炎。
