Cuko L, Bilaj F, Bega B, Barbullushi A, Resuli B
Department of Gastro-Hepatology, Radiology, Laboratory, University Hospital Center "Mother Teresa", Tirana, Albania.
Hippokratia. 2014 Jul-Sep;18(3):275-7.
Eosinophilic ascites is the most unusual presentation of eosinophilic gastroenteritis (EGE), caused by edema and eosinophilic inflammation of the small bowel wall's serosal layer.
We report the case of a 37-year-old woman, who presented with diffuse abdominal pain, nausea, abdominal distension, moderate ascites and diarrhea of two weeks duration. The rest of physical and clinical examination was unremarkable, and her past medical history was uneventful. Magnetic Resonance Imaging showed the presence of ascites and diffuse thickening of small bowel wall, but did not detect a primary malignancy in the abdominal cavity; and no signs of portal hypertension or liver damage. Laboratory test results revealed essential peripheral blood eosinophilia, elevated serum IgE and marked increase of eosinophils in the abdominal fluid. Treatment with corticosteroids normalized laboratory tests results, and the ascites resolved immediately.
EGE is a rare entity and it should be kept in mind in patients of unexplained ascites. The absence of primary malignancy on imaging, coupled with marked increase of fluid esinophilia and immediate response to treatment with steroids, confirm indirectly the diagnosis of EGE. Hippokratia 2014; 18 (3): 275-277.
嗜酸性腹水是嗜酸性胃肠炎（EGE）最不常见的表现形式，由小肠壁浆膜层的水肿和嗜酸性炎症引起。
我们报告一例37岁女性患者，出现弥漫性腹痛、恶心、腹胀、中度腹水及持续两周的腹泻。其余体格检查和临床检查无异常，既往病史也无特殊。磁共振成像显示存在腹水及小肠壁弥漫性增厚，但未在腹腔内检测到原发性恶性肿瘤；也无门静脉高压或肝损伤迹象。实验室检查结果显示外周血嗜酸性粒细胞增多、血清IgE升高且腹水中嗜酸性粒细胞显著增加。使用皮质类固醇治疗使实验室检查结果恢复正常，腹水立即消退。
EGE是一种罕见疾病，对于不明原因腹水的患者应予以考虑。影像学检查未发现原发性恶性肿瘤，再加上腹水嗜酸性粒细胞显著增加以及对类固醇治疗的即时反应，间接证实了EGE的诊断。《希波克拉底》2014年；18（3）：275 - 277。
