Kanno Hiroyuki, Ouchi Naohisa, Sato Masatoshi, Wada Tsukasa, Sawai Takashi
Department of Pathology, Iwate Medical University School of Medicine, Morioka, Japan.
Hum Pathol. 2005 May;36(5):585-9. doi: 10.1016/j.humpath.2005.03.017.
A 34-year-old Japanese woman developed subcutaneous induration in the left thigh, then showed extreme eosinophilia, and died of hemorrhagic infarction of the brain. Autopsy revealed endocarditis with eosinophil infiltration and systemic thrombophlebitis, including pulmonary veins and intrahepatic branches of the portal vein. Arterial structure was relatively preserved. She had no clinical history of asthma and had anti-ascarid IgE antibody at postmortem serological examination; thus, her disease does not fulfill the diagnostic criteria of Churg-Strauss syndrome and idiopathic hypereosinophilic syndrome (HES). Her organ involvement is, however, consistent with that of HES; thus, her pathophysiological conditions would resemble those of HES. Systemic thrombophlebitis without arterial lesion in patients with hypereosinophilia has never been reported, and this case would broaden the spectrum of vascular lesions in these patients.
一名34岁的日本女性左大腿出现皮下硬结，随后出现极度嗜酸性粒细胞增多，最终死于脑出血性梗死。尸检显示心内膜炎伴嗜酸性粒细胞浸润以及包括肺静脉和门静脉肝内分支在内的系统性血栓性静脉炎。动脉结构相对保存完好。她没有哮喘的临床病史，死后血清学检查发现有抗蛔虫IgE抗体；因此，她的疾病不符合Churg-Strauss综合征和特发性嗜酸性粒细胞增多综合征（HES）的诊断标准。然而，她的器官受累情况与HES相符；因此，她的病理生理状况可能与HES相似。嗜酸性粒细胞增多患者出现无动脉病变的系统性血栓性静脉炎此前从未有过报道，该病例将拓宽这些患者血管病变的范围。
