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两姐妹因哮喘家族史腹痛就诊,被诊断为嗜酸性粒细胞性胃肠炎。姐姐 25 岁,妹妹 27 岁。

Abdominal Pain Due to Eosinophilic Gastroenteritis Diagnosed in 25-Year-Old and 27-Year-Old Sisters with a Family History of Asthma.

机构信息

Allergy and Clinical Immunology Division, Internal Medicine Department, Faculty of Medicine Public Health and Nursing Gadjah Mada University, Yogyakarta, Indonesia.

Gastroentero-Hepatology Division, Internal Medicine Department, Faculty of Medicine Public Health and Nursing Gadjah Mada University, Yogyakarta, Indonesia.

出版信息

Am J Case Rep. 2023 Mar 19;24:e938232. doi: 10.12659/AJCR.938232.

Abstract

BACKGROUND Eosinophilic gastroenteritis (EG) can be associated with parasitic infections, atopic drug reactions, or atopic diseases, such as asthma. This report describes 25-year-old and 27-year-old sisters with a family history of asthma who presented with abdominal pain due to EG. CASE REPORT Case 1: A 25-year-old woman presented with a 4-month history of chronic left upper quadrant abdominal pain that did not improve with proton pump inhibitor and sucralfate therapy. She has a history of asthma and allergic rhinitis. Endoscopic pathology revealed pangastritis, with eosinophilic infiltration >25 per 1 high power field. Case 2: Her 27-year-old sister was admitted with chronic abdominal discomfort in the form of vomiting and recurrent abdominal pain for the past 2 years. Treatment with proton pump inhibitors and sucralfate did not lead to improvement. She also had intermittent asthma. Pathological findings on her endoscopy showed chronic inflammation of the fundus and antrum, with eosinophilic infiltration >40 per 1 high power field. Association of eosinophilic gastrointestinal diseases in siblings has not been reported previously. CONCLUSIONS This report has highlighted that atopic disease, such as asthma, is often familial, and can be associated with generalized eosinophilia, including EG. In these 2 sisters, the clinical history and histological findings on colonic biopsy were important to confirm the diagnosis.

摘要

背景

嗜酸性粒细胞性胃肠炎(EG)可与寄生虫感染、特应性药物反应或特应性疾病(如哮喘)相关。本报告描述了一对有哮喘家族史的 25 岁和 27 岁姐妹,因 EG 出现腹痛。

病例报告

病例 1:一名 25 岁女性因慢性左上腹疼痛就诊,病史 4 个月,质子泵抑制剂和硫糖铝治疗无效。她有哮喘和过敏性鼻炎病史。内镜病理显示全胃炎,嗜酸性粒细胞浸润>25/高倍视野。

病例 2:她 27 岁的妹妹因慢性腹部不适、呕吐和反复发作性腹痛入院,病史 2 年。质子泵抑制剂和硫糖铝治疗无效。她也有间歇性哮喘。内镜检查的病理发现胃底和胃窦的慢性炎症,嗜酸性粒细胞浸润>40/高倍视野。

以前没有报道过嗜酸性粒细胞性胃肠道疾病在兄弟姐妹中的关联。

结论

本报告强调,特应性疾病(如哮喘)常具有家族性,可与全身性嗜酸性粒细胞增多有关,包括 EG。在这 2 位姐妹中,结肠活检的临床病史和组织学发现对确诊很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8147/10037115/de98db392c6d/amjcaserep-24-e938232-g001.jpg

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