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嗜酸性胰腺炎:病理生理学、诊断及治疗综述

Eosinophilic pancreatitis: a review of the pathophysiology, diagnosis, and treatment.

作者信息

Sun Yue, Pan Dan, Kang Kai, Sun Ming-Jun, Li Yi-Ling, Sang Li-Xuan, Chang Bing

机构信息

Department of Gastroenterology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, P. R. China.

Department of Geriatrics, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, P. R. China.

出版信息

Gastroenterol Rep (Oxf). 2020 Dec 12;9(2):115-124. doi: 10.1093/gastro/goaa087. eCollection 2021 Apr.

Abstract

Eosinophilic pancreatitis (EP) is an extremely rare disease caused by purely eosinophilic infiltration of the pancreas. EP is prone to being misdiagnosed as pancreatic cancer, causing unnecessary economic and physical harm to the patient. We report three cases of EP that were cured by steroids without relapse from 2017 to now. The clinical data of the three patients, including clinical manifestations, serological manifestations, imaging (ultrasound, computed tomography, and MRI), pathological diagnosis and treatment, and telephone follow-up of all patients, were retrospectively analysed. In addition, a literature search was conducted on the Web of Science and PubMed databases using key terms related to EP, considering case reports with no restrictions on the date of publication or language. In conclusion, we analysed 19 cases and determined the diagnostic criteria for EP. The diagnostic algorithm for EP can be used to diagnose EP easily. We hope that our standards and algorithm can reduce the rate of misdiagnosis and contribute to clinical diagnosis and treatment. In addition, we expect to evaluate more EP cases to test our diagnostic criteria and design a systematic diagnostic flow chart.

摘要

嗜酸性胰腺炎(EP)是一种极为罕见的疾病,由胰腺单纯嗜酸性粒细胞浸润引起。EP容易被误诊为胰腺癌,给患者造成不必要的经济和身体伤害。我们报告了2017年至今经类固醇治疗治愈且未复发的3例EP病例。对这3例患者的临床资料,包括临床表现、血清学表现、影像学(超声、计算机断层扫描和磁共振成像)、病理诊断与治疗以及对所有患者的电话随访进行了回顾性分析。此外,在科学网(Web of Science)和PubMed数据库中使用与EP相关的关键词进行文献检索,纳入不限发表日期或语言的病例报告。总之,我们分析了19例病例并确定了EP的诊断标准。EP的诊断算法可用于轻松诊断EP。我们希望我们的标准和算法能够降低误诊率,为临床诊断和治疗提供帮助。此外,我们期望评估更多的EP病例以检验我们的诊断标准并设计出系统的诊断流程图。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57bd/8128011/63887f12a44d/goaa087f1.jpg

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