Gollub S B, Huntrakoon M, Dunn M I
Department of Medicine, University of Kansas Medical Center, Kansas City.
Am J Cardiovasc Pathol. 1990;3(1):21-6.
The presence of eosinophils has previously been associated with severe acute cardiac allograft rejection. This appears to be a relatively uncommon finding, judging from our experience and the paucity of information appearing in literature. We report three cases where a prominent infiltrate of eosinophils was noted on endomyocardial biopsy following cardiac transplantation. There was no evidence of severe acute rejection in any of these three patients, and one patient had only mild acute rejection without even focal myocardial necrosis. An infiltrate, which includes eosinophils, does not appear to be restricted to severe acute cardiac allograft rejection. Therefore, when eosinophils are noted in endomyocardial biopsy specimens, decisions to revise the immunosuppressive regimen of cardiac transplant recipients should continue to be based upon established conventional histologic criteria.
嗜酸性粒细胞的存在此前一直与严重的急性心脏移植排斥反应相关。从我们的经验以及文献中出现的信息匮乏情况来看，这似乎是一个相对不常见的发现。我们报告了3例心脏移植后心内膜心肌活检发现显著嗜酸性粒细胞浸润的病例。这3例患者均无严重急性排斥反应的证据，其中1例患者仅有轻度急性排斥反应，甚至没有局灶性心肌坏死。包括嗜酸性粒细胞在内的浸润似乎并不局限于严重的急性心脏移植排斥反应。因此，当在心内膜心肌活检标本中发现嗜酸性粒细胞时，调整心脏移植受者免疫抑制方案的决策仍应基于既定的传统组织学标准。
