Chien Andy J, Argenyi Zsolt B, Colven Roy M, Kirby Philip
University of Washington Department of Medicine, Division of Dermatology, Seattle, Washington 98195, USA.
J Am Acad Dermatol. 2004 Nov;51(5 Suppl):S151-5. doi: 10.1016/j.jaad.2004.04.018.
Our report describes a previously healthy 10-year-old female who was seen for urticarial plaques and mild loss of appetite. An initial laboratory workup revealed an elevated leukocyte count of 30,000/microL and a peripheral eosinophil count of 22,500/microL. A skin biopsy showed a marked hypersensitivity tissue response with abundant eosinophils. Further investigation of her peripheral eosinophilia uncovered Giardia lamblia in a stool sample. Despite treatment with the anti-parasitic agent furazolidone, the patient's urticarial plaques, leukocyte count, and peripheral eosinophil count remained unchanged. A bone marrow biopsy confirmed a diagnosis of acute lymphoblastic leukemia (ALL). ALL with hypereosinophilia (ALL/Eo) represents a rare and distinct subset of ALL, with more than 30 cases documented in the literature. Our discussion summarizes the clinical aspects of this disease and reviews the reported dermatological manifestations of ALL/Eo.
我们的报告描述了一名此前健康的10岁女性，她因出现荨麻疹斑块和轻度食欲不振前来就诊。初步实验室检查显示白细胞计数升高至30,000/微升，外周嗜酸性粒细胞计数为22,500/微升。皮肤活检显示有明显的超敏组织反应，伴有大量嗜酸性粒细胞。对她外周嗜酸性粒细胞增多症的进一步检查发现粪便样本中有蓝氏贾第鞭毛虫。尽管使用抗寄生虫药物呋喃唑酮进行了治疗，但患者的荨麻疹斑块、白细胞计数和外周嗜酸性粒细胞计数仍未改变。骨髓活检确诊为急性淋巴细胞白血病（ALL）。伴有嗜酸性粒细胞增多的ALL（ALL/Eo）是ALL中一个罕见且独特的亚组，文献中记载的病例超过30例。我们的讨论总结了该疾病的临床方面，并回顾了报道的ALL/Eo的皮肤表现。
