Wienand B, Sanner B, Liersch M
Gastroenterologische Abteilung, Evangelisches Krankenhaus Hamm.
Dtsch Med Wochenschr. 1991 Mar 8;116(10):371-4. doi: 10.1055/s-2008-1063622.
One week after treatment of a urinary infection with co-trimoxazole (twice daily 160 mg trimethoprim and 800 mg sulphamethoxazole) a 21-year-old man suddenly started to vomit, accompanied by watery diarrhoea, abdominal swelling and weight loss of 5 kg. Plain X-ray film of the abdomen while standing showed multiple fluid levels in the small intestine of the upper and lower abdomen. Serum IgE concentration was elevated to 325 U/ml. There was a leukocytosis of 25,800/microliters, with a differential count of 45% eosinophils. Protein-rich ascites contained numerous eosinophils and the mucosa of the terminal ileus and the duodenum was infiltrated with eosinophils, findings which indicated eosinophilic gastroenteritis. All symptoms regressed completely within 10 days of stopping co-trimoxazole and administering prednisolone (50 mg/day). Four years later a similar episode of eosinophilic gastroenteritis developed after the patient had taken trimethoprim with a sulphonamide (once daily 180 mg trimethoprim and 820 mg sulphadiazine). It again quickly responded to short-term administration of glucocorticoids.
一名21岁男性在使用复方新诺明（每日两次，每次160毫克甲氧苄啶和800毫克磺胺甲恶唑）治疗泌尿系统感染一周后，突然开始呕吐，伴有水样腹泻、腹部肿胀和体重减轻5千克。站立位腹部平片显示上腹部和下腹部小肠有多个液平面。血清IgE浓度升高至325 U/ml。白细胞计数为25,800/微升，嗜酸性粒细胞分类计数为45%。富含蛋白质的腹水中含有大量嗜酸性粒细胞，末端回肠和十二指肠黏膜有嗜酸性粒细胞浸润，这些发现提示嗜酸性粒细胞性胃肠炎。在停用复方新诺明并给予泼尼松龙（50毫克/天）后，所有症状在10天内完全消退。四年后，该患者在服用甲氧苄啶与磺胺嘧啶（每日一次，每次180毫克甲氧苄啶和820毫克磺胺嘧啶）后，再次发生类似的嗜酸性粒细胞性胃肠炎发作。再次短期给予糖皮质激素后，病情又迅速得到缓解。
