Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan.
Department of Gastroenterology, Juntendo University, Japan.
Intern Med. 2020;59(16):1977-1981. doi: 10.2169/internalmedicine.4554-20. Epub 2020 Aug 15.
A 45-year-old man with steroid-dependent ulcerative pancolitis was hospitalized with frequent diarrhea, abdominal pain and distension 3 months after induction of golimumab, a tumor necrosis factor-alpha antagonist. Computed tomography showed wall thickening from the stomach to the colon and massive ascites. Peripheral blood test revealed eosinophilia. A large number of eosinophils were observed in the ascites fluid. Although esophagogastroduodenoscopy showed no abnormal findings and colonoscopy showed ulcerative colitis with a Mayo endoscopic subscore of 1, eosinophil infiltration was histologically observed. Based on these findings, we diagnosed him with eosinophilic gastroenteritis and started prednisolone. Consequently, his eosinophil counts and abdominal symptoms dramatically improved.
一位 45 岁男性因类固醇依赖型溃疡性全结肠炎，在接受肿瘤坏死因子-α拮抗剂戈利木单抗诱导治疗 3 个月后因频繁腹泻、腹痛和腹胀住院。计算机断层扫描显示从胃到结肠的壁增厚和大量腹水。外周血检查显示嗜酸性粒细胞增多。腹水液中观察到大量嗜酸性粒细胞。尽管食管胃十二指肠镜检查未发现异常，结肠镜检查显示溃疡性结肠炎的 Mayo 内镜亚评分 1，但组织学观察到嗜酸性粒细胞浸润。根据这些发现，我们诊断为嗜酸性粒细胞性胃肠炎，并开始使用泼尼松龙治疗。随后，他的嗜酸性粒细胞计数和腹部症状明显改善。
