Department of Gastroenterology, Kitasato University East Hospital, Kanagawa, Japan.
Dig Endosc. 2010 Oct;22(4):312-5. doi: 10.1111/j.1443-1661.2010.01012.x.
We describe a 54-year-old man who presented with right subcostal pain. Minocycline had been prescribed to treat pruritus, and the symptoms resolved. Subsequently, the patient consulted a local physician because of right subcostal pain. Giant folds were found in the greater curvature of the gastric body, and he was referred to the Department of Gastroenterology, Kitasato University East Hospital. Upper gastrointestinal endoscopy revealed markedly enlarged folds in the greater curvature of the stomach, with redness and edematous mucosa in the lesser curvature. Biopsy showed marked inflammatory cell infiltration (mainly eosinophils), but no atypical cells. Blood tests showed marked eosinophilia and elevated immunoglobulin E levels in the serum. The results of various allergic examinations were negative, but the clinical course suggested drug-induced eosinophilic gastroenteritis, and treatment was started. Minocycline was withdrawn without adequate resolution of symptoms. Because the leukocyte and eosinophil counts continued to increase, the patient was given suplatast, an anti-allergic agent. The symptoms and hematological values improved promptly. The patient recovered uneventfully, with no recurrence.
我们描述了一位 54 岁的男性患者，他因右侧肋下疼痛就诊。曾因瘙痒而开处米诺环素治疗，症状缓解。随后，因右侧肋下疼痛，患者咨询当地医生。发现胃体大弯处有巨大皱襞，转至甲南大学东医院消化内科。上消化道内镜检查显示胃大弯处明显增大的皱襞，小弯处黏膜红肿伴水肿。活检显示明显的炎症细胞浸润（主要为嗜酸性粒细胞），但未见非典型细胞。血液检查显示嗜酸性粒细胞明显增多，血清免疫球蛋白 E 水平升高。各种过敏检查结果均为阴性，但临床过程提示药物诱导的嗜酸性粒细胞性胃肠炎，开始治疗。米诺环素停药后症状无明显缓解。由于白细胞和嗜酸性粒细胞计数持续增加，给予抗过敏药物苏普拉司他治疗。症状和血液学值迅速改善。患者恢复顺利，无复发。
