Stockner Ingrid, Thaler Josef, Fichtel Gertrud, Egarter-Vigl Eduard, Wallnöfer Werner, Wiedermann Christian J
Department of Internal Medicine, Central Hospital of Bolzano, Bolzano, Italy.
Clin Rheumatol. 2008 Dec;27(12):1573-6. doi: 10.1007/s10067-008-0990-1. Epub 2008 Aug 15.
Episodic angioedema with eosinophilia is characterized by recurrent angioedema, peripheral eosinophilia, fever, weight gain, elevated serum immunoglobulin M (IgM), and a benign course lacking any internal organ involvement. A non-episodic variant has also been reported which is limited to a single attack and normally is less severe than the episodic type. We report a case of Mycoplasma pneumoniae infection with dermatological manifestation that was followed by non-episodic angioedema with eosinophilia including fever, weight gain, and elevated serum IgM. Even though the patient's clinical characteristics resemble episodic angioedema with eosinophilia as reported by Gleich, angioedema was non-episodic. This may be due to systemic corticosteroid treatment which was prescribed because of persistent skin manifestation following M. pneumoniae infection. The current report is the first observation suggesting that angioedema associated with eosinophilia may be triggered by atypical bacterial infection.
伴有嗜酸性粒细胞增多的发作性血管性水肿的特征为反复出现血管性水肿、外周血嗜酸性粒细胞增多、发热、体重增加、血清免疫球蛋白M（IgM）升高，且病程良性，无任何内脏器官受累。也有报道称存在非发作性变体，其仅限于单次发作，通常比发作性类型症状较轻。我们报告一例肺炎支原体感染伴皮肤表现的病例，随后出现伴有嗜酸性粒细胞增多的非发作性血管性水肿，包括发热、体重增加和血清IgM升高。尽管该患者的临床特征类似于Gleich报道的伴有嗜酸性粒细胞增多的发作性血管性水肿，但此次血管性水肿为非发作性。这可能是由于肺炎支原体感染后持续存在皮肤表现而给予的全身性皮质类固醇治疗所致。本报告是首次观察到提示与嗜酸性粒细胞增多相关的血管性水肿可能由非典型细菌感染引发。
