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[嗜酸性粒细胞增多症的鉴别诊断]

[Differential diagnosis of hypereosinophilia].

作者信息

Henes J C, Wirths S, Hellmich B

机构信息

Zentrum für Interdisziplinäre Klinische Immunologie, Rheumatologie und Autoimmunerkrankungen (INDIRA), Universitätsklinikum, Otfried-Müller-Str. 10, 72076, Tübingen, Deutschland.

Medizinische Klinik II (Onkologie, Hämatologie, Klinische Immunologie, Rheumatologie und Pulmologie), Universitätsklinikum Tübingen, Tübingen, Deutschland.

出版信息

Z Rheumatol. 2019 May;78(4):313-321. doi: 10.1007/s00393-018-0587-2.

Abstract

Eosinophilia is defined as an elevated absolute number of eosinophilic leukocytes in peripheral blood or tissue. Its absolute number also defines the grade of eosinophilia. The main causes are allergic (including drug side effects) and infectious triggers but malignant and autoimmune diseases can also result in eosinophilia. Severe eosinophilia with the number of eosinophils >5000/µl are mostly caused by myeloproliferative disorders, eosinophilic granulomatosis with polyangiitis or during tissue migration in parasitic tissue infections. Hypereosinophilic syndrome is defined as eosinophilia with >1500 eosinophils/µl and a duration of more than 6 months by exclusion of parasitic infections, allergies or other causes of tissue eosinophilia with end-organ damage. For the diagnosis of a persistent eosinophilia a detailed medical history and physical examination should be followed by early organ screening, infection diagnostics especially for helminth infections and hematological laboratory analyses including bone marrow investigations.

摘要

嗜酸性粒细胞增多症定义为外周血或组织中嗜酸性粒细胞的绝对数量升高。其绝对数量也定义了嗜酸性粒细胞增多症的分级。主要病因是过敏(包括药物副作用)和感染诱因,但恶性疾病和自身免疫性疾病也可导致嗜酸性粒细胞增多症。嗜酸性粒细胞计数>5000/µl的严重嗜酸性粒细胞增多症主要由骨髓增殖性疾病、嗜酸性肉芽肿性多血管炎或寄生虫组织感染时的组织迁移引起。高嗜酸性粒细胞综合征定义为嗜酸性粒细胞计数>1500/µl且持续时间超过6个月,排除寄生虫感染、过敏或其他伴有终末器官损害的组织嗜酸性粒细胞增多症病因。对于持续性嗜酸性粒细胞增多症的诊断,应在详细的病史和体格检查之后,进行早期器官筛查、感染诊断,尤其是针对蠕虫感染的诊断,以及包括骨髓检查在内的血液学实验室分析。

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