Harada Taku, Kosaka Shintaro, Nakai Mori
Department of General Medicine, Nerima Hikarigaoka Hospital, Tokyo, Japan.
Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Tochigi, Japan.
Eur J Case Rep Intern Med. 2022 Dec 29;9(12):003671. doi: 10.12890/2022_003671. eCollection 2022.
Non-episodic angioedema associated with eosinophilia (NEAE) has been reported primarily in young East Asian women and is characterized by a single episode of persistent limb oedema, peripheral eosinophilia, and transient joint pain. Although there are reports of eosinophilia disease after coronavirus disease 2019 (COVID-19), the occurrence of NEAE has not been previously reported.
A 29-year-old Japanese woman, with a history of allergic rhinitis and atopic dermatitis, sought a medical consultation for persisting oedema of the extremities, which developed about 2 weeks after she contracted COVID-19. Physical examination revealed symmetrical non-pitting oedema with peripheral predominance. Laboratory examination revealed a blood eosinophil count of 7536/μl. The patient was diagnosed with NEAE and a 7-day course of prednisolone (15 mg/day) was initiated, with rapid improvement in the oedema and no recurrence on follow-up.
The exact aetiology of NEAE is unknown, but it may develop after infection or drug exposure. Eosinophilic disease after COVID-19 infection has been reported and, therefore, eosinophilic angioedema should be considered in the differential diagnosis of non-pitting oedema of the extremities after a COVID-19 infection. Early diagnosis of NEAE is important as rapid improvement can be achieved with low-dose steroid treatment.
NEAE can develop after COVID-19 and should be considered in the differential diagnosis of non-pitting oedema of the extremities.
Non-episodic angioedema associated with eosinophilia (NEAE) is characterized by a single episode of symmetrical non-pitting oedema with distal limb predominance.The case presented indicates that NEAE can occur after COVID-19 infection.Therefore, eosinophilic angioedema should be considered in the differential diagnosis of non-pitting oedema of the extremities in a patient with a positive COVID-19 history.
与嗜酸性粒细胞增多相关的非发作性血管性水肿（NEAE）主要在年轻东亚女性中被报道，其特征为单次发作的持续性肢体水肿、外周嗜酸性粒细胞增多以及短暂的关节疼痛。尽管有关于2019冠状病毒病（COVID - 19）后嗜酸性粒细胞增多性疾病的报道，但NEAE的发生此前尚未见报道。
一名29岁的日本女性，有过敏性鼻炎和特应性皮炎病史，因COVID - 19感染约2周后出现的持续性肢体水肿前来就医。体格检查发现对称性非凹陷性水肿，以肢体远端为主。实验室检查显示血液嗜酸性粒细胞计数为7536/μl。该患者被诊断为NEAE，并开始了为期7天的泼尼松龙治疗疗程（15毫克/天），水肿迅速改善且随访无复发。
NEAE的确切病因尚不清楚，但可能在感染或接触药物后发生。COVID - 19感染后嗜酸性粒细胞增多性疾病已有报道，因此，在COVID - 19感染后肢体非凹陷性水肿的鉴别诊断中应考虑嗜酸性粒细胞性血管性水肿。NEAE的早期诊断很重要，因为低剂量类固醇治疗可实现快速改善。
NEAE可在COVID - 19后发生，在肢体非凹陷性水肿的鉴别诊断中应予以考虑。
与嗜酸性粒细胞增多相关的非发作性血管性水肿（NEAE）的特征为单次发作的对称性非凹陷性水肿，以肢体远端为主。本病例表明NEAE可在COVID - 19感染后发生。因此，对于有COVID - 19阳性病史的患者，在肢体非凹陷性水肿的鉴别诊断中应考虑嗜酸性粒细胞性血管性水肿。
