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结节性多动脉炎伴显著嗜酸性粒细胞增多，合并严重胃肠道受累及复发性静脉血栓形成。

Polyarteritis Nodosa with Marked Eosinophilia, Associated with Severe Gastrointestinal Tract Involvement and Recurrent Venous Thrombosis.

作者信息

Oiwa Hiroshi, Taniguchi Kohei, Miyoshi Natsuki, Sasaki Keiko, Ichimura Kouichi, Kubota Tetsushi, Sato Daisuke

机构信息

Department of Rheumatology, Hiroshima City Hiroshima Citizens Hospital, Japan.

Department of Pathology, Hiroshima City Hiroshima Citizens Hospital, Japan.

出版信息

Intern Med. 2019 Oct 15;58(20):3051-3055. doi: 10.2169/internalmedicine.2802-19. Epub 2019 Jun 27.

DOI:10.2169/internalmedicine.2802-19
PMID:31243218
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6859400/
Abstract

A 45-year-old man was admitted with acute abdominal pain and eosinophilia. Abdominal computed tomography revealed thickness of the ascending and transverse colon with decreased contrast enhancement and a small amount of ascites. In an emergency operation, the necrotic colon was resected. Histopathology showed subserous medium-sized arteritis with abundant eosinophil infiltrates and thrombosis in the portal vein branches. He was diagnosed with polyarteritis nodosa (PAN), and immunosuppressive therapy improved his condition. Two years later, the disease recurred with ischemic cutaneous lesions and marked eosinophilia. Our experience suggests that marked eosinophilia in PAN may imply severe organ involvement, including gastrointestinal necrosis, as well as the association of venous thrombosis.

摘要

一名45岁男性因急性腹痛和嗜酸性粒细胞增多症入院。腹部计算机断层扫描显示升结肠和横结肠增厚，增强扫描强化减弱，并有少量腹水。在急诊手术中，切除了坏死的结肠。组织病理学显示浆膜下中型动脉炎，伴有大量嗜酸性粒细胞浸润和门静脉分支血栓形成。他被诊断为结节性多动脉炎（PAN），免疫抑制治疗使病情得到改善。两年后，疾病复发，出现缺血性皮肤病变和明显的嗜酸性粒细胞增多。我们的经验表明，PAN中明显的嗜酸性粒细胞增多可能意味着严重的器官受累，包括胃肠道坏死，以及静脉血栓形成的关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bcc/6859400/b5b062f79723/1349-7235-58-3051-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bcc/6859400/cd51dced2cc4/1349-7235-58-3051-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bcc/6859400/9315c9057960/1349-7235-58-3051-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bcc/6859400/fb64581f2411/1349-7235-58-3051-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bcc/6859400/19b1cf24096d/1349-7235-58-3051-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bcc/6859400/b5b062f79723/1349-7235-58-3051-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bcc/6859400/cd51dced2cc4/1349-7235-58-3051-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bcc/6859400/9315c9057960/1349-7235-58-3051-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bcc/6859400/fb64581f2411/1349-7235-58-3051-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bcc/6859400/19b1cf24096d/1349-7235-58-3051-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bcc/6859400/b5b062f79723/1349-7235-58-3051-g005.jpg

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World Health Organization-defined eosinophilic disorders: 2017 update on diagnosis, risk stratification, and management.世界卫生组织定义的嗜酸性粒细胞疾病：2017 年诊断、风险分层和管理更新。
Am J Hematol. 2017 Nov;92(11):1243-1259. doi: 10.1002/ajh.24880.
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