Butterfield Joseph H, Murray Joseph A
Division of Allergic Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, U.S.A.
J Clin Gastroenterol. 2002 May-Jun;34(5):552-3. doi: 10.1097/00004836-200205000-00014.
We report the clinical and laboratory features of a 19-year-old man with findings of both eosinophilic gastroenteritis and gluten-sensitive enteropathy. Before the onset of clinical symptoms, the patient had received a series of hepatitis B vaccinations but had not developed a measurable antibody response or any allergic reaction. Radioallergosorbent test results were positive to several foods, and the total serum immunoglobulin E (IgE) level was elevated. Adherence to a gluten-free diet caused a normalization in the endomysial antibody titer; however, the total serum IgE level continued to increase, and the total eosinophil count remained elevated. Symptoms of recurrent vomiting and abdominal pain necessitated prednisone burst therapy. The simultaneous occurrence of eosinophilic gastroenteritis and gluten-sensitive enteropathy is rare; therapy should be directed to each disorder individually.
我们报告了一名19岁男性的临床和实验室特征，该患者同时患有嗜酸性粒细胞性胃肠炎和麸质敏感性肠病。在临床症状出现之前，患者接受了一系列乙肝疫苗接种，但未产生可测量的抗体反应或任何过敏反应。放射性变应原吸附试验结果显示对多种食物呈阳性，血清总免疫球蛋白E（IgE）水平升高。坚持无麸质饮食使肌内膜抗体滴度恢复正常；然而，血清总IgE水平持续升高，嗜酸性粒细胞总数仍居高不下。反复呕吐和腹痛症状需要进行泼尼松冲击治疗。嗜酸性粒细胞性胃肠炎和麸质敏感性肠病同时出现的情况很少见；治疗应针对每种疾病分别进行。
