Simoniuk Urszula, McManus Chris, Kiire Clement
Surgery Department, Southport General Hospital, Southport, UK.
BMJ Case Rep. 2012 Aug 13;2012:bcr1220115436. doi: 10.1136/bcr.12.2011.5436.
Eosinophilic gastroenteritis is a heterogeneous and curable disease of the gastrointestinal tract. The diagnosis is rare, with an approximate incidence of 1/100,000. The pathophysiology is based on infiltration of the eosinophils involving various parts of gastrointestinal system, but also different layers of the wall. The authors present a case of the eosinophilic gastroenteritis, which is characterised by the predominant subserosal type associated with asthma, ascites and bilateral pleural effusion. In patients with asthma and abdominal symptomatology, eosinophilic gastroenteritis should be considered as a possible diagnosis. These two atopic conditions may occur more frequently than generally expected, especially in the presence of protein-losing gastroenteropathy. ▸ Consider a diagnosis of eosinophilic gastroenteritis in patients with atopy and gastrointestinal symptoms. ▸ Histological demonstration of the gastrointestinal tract and/or ascites. ▸ Exclude other causes of eosinophilia such as parasites, Churg-Strauss syndrome, hypereosinophilic syndrome.
嗜酸性粒细胞性胃肠炎是一种异质性且可治愈的胃肠道疾病。其诊断较为罕见,发病率约为1/100,000。病理生理学基于嗜酸性粒细胞浸润胃肠道系统的各个部位以及肠壁的不同层次。作者报告了一例嗜酸性粒细胞性胃肠炎病例,其特征为主要是浆膜下型,伴有哮喘、腹水和双侧胸腔积液。对于有哮喘和腹部症状的患者,应考虑嗜酸性粒细胞性胃肠炎作为可能的诊断。这两种特应性疾病的发生可能比一般预期更为频繁,尤其是在存在蛋白丢失性胃肠病的情况下。
▸ 对于有特应性和胃肠道症状的患者,考虑诊断为嗜酸性粒细胞性胃肠炎。
▸ 进行胃肠道和/或腹水的组织学证实。
▸ 排除嗜酸性粒细胞增多的其他原因,如寄生虫、变应性肉芽肿性血管炎、高嗜酸性粒细胞综合征。