1 Department of Pediatrics, University-Medical Centre Hamburg-Eppendorf, Germany. 2 Department of Pediatric Infectious Diseases, University-Medical Centre Hamburg-Eppendorf, Germany. 3 Department of Pediatric Gastroenterology, Hepatology and Liver Transplantation, University-Medical Centre Hamburg-Eppendorf, Germany. 4 Institute of Pathology, University-Medical Centre Hamburg-Eppendorf, Germany. 5 Department of Pediatric Nephrology and Kidney Transplantation, University-Medical Centre Hamburg-Eppendorf, Germany. 6 Department of Pediatrics, Heidberg-Hospital, Hamburg, Germany.
Transplantation. 2017 May;101(5):e166-e169. doi: 10.1097/TP.0000000000001721.
Persistently elevated eosinophil granulocytes in the peripheral blood in children is challenging because of a complex diagnosis especially after solid organ transplantation and can lead to difficulties in finding an underlying causative factor.We report a 12-year-old boy who developed severe hypereosinophilia 11 years after liver transplantation due to biliary atresia. Accompanying symptoms were recurrent fever, fatigue, elevated liver enzymes, abdominal pain, and significant weight loss. After exclusion of secondary causes of eosinophilia, an idiopathic hypereosinophilic syndrome (I-HES) was diagnosed. Treatment with prednisolone resulted in an immediate response with rapid reduction of eosinophils, normalization of liver enzymes, and amelioration of any clinical symptoms. A hypereosinophilic syndrome in patients after liver transplantation is rare, and a broad differential diagnosis has to be considered. Prednisolone may lead to a prompt amelioration of eosinophilia and associated symptoms.
儿童外周血中持续性嗜酸性粒细胞增多具有挑战性，因为诊断复杂，尤其是在实体器官移植后，这可能导致难以找到潜在的致病因素。我们报告了 1 例 12 岁男孩，在胆道闭锁肝移植 11 年后发生严重嗜酸性粒细胞增多症。伴随症状有反复发热、疲劳、肝酶升高、腹痛和明显体重减轻。在排除嗜酸性粒细胞增多的继发原因后，诊断为特发性嗜酸性粒细胞增多症（I-HES）。泼尼松龙治疗立即起效，嗜酸性粒细胞迅速减少，肝酶正常化，任何临床症状均得到改善。肝移植后患者发生嗜酸性粒细胞增多症较为罕见，需要考虑广泛的鉴别诊断。泼尼松龙可能会迅速改善嗜酸性粒细胞增多和相关症状。
