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[眼眶前部炎性假瘤。变应性肉芽肿性血管炎(Churg-Strauss综合征)的一种症状]

[Inflammatory pseudotumor of the anterior orbit. A symptom in allergic granulomatous angiitis (Churg-Strauss syndrome)].

作者信息

Heine A, Beck R, Stropahl G, Unger K, Guthoff R

机构信息

Universitäts-Augenklinik Rostock.

出版信息

Ophthalmologe. 1995 Dec;92(6):870-3.

PMID:8563441
Abstract

Allergic granulomatosis accompanied by angiitis (Churg-Strauss syndrome) constitutes an unusual disorder which is characterized clinically by bronchial asthma and hypereosinophilia, accompanied by systemic symptoms of histopathologically and by necrotizing vasculitis, extravascular granulomas and tissue infiltration by eosinophils. We report a case of a 4 year-old child presenting with acute pneumonia and deteriorated general condition. The biopsy of an inflammatory pseudotumor of the right anterior orbit revealed necrotizing vasculitis, extravascular epitheloid granuloma and eosinophilic tissue infiltration. These are characteristic changes of allergic granulomatous vasculitis (Churg-Strauss syndrome. Laboratory findings were characterized by blood eosinophilia, increased IgE value and the presence of antineutrophil cytoplasmic ant antibodies (p-ANCA). Local and systemic manifestations quickly regressed after parenteral application of corticosteroids. Two exacerbations of inflammatory pseudotumor occurred after reduction of the corticosteroid dosage. Systemic vasculitic syndromes are rare in childhood. Orbital manifestations in Churg-Strauss syndrome in childhood have never been reported.

摘要

变应性肉芽肿伴血管炎(Churg-Strauss综合征)是一种罕见的疾病,临床特征为支气管哮喘和嗜酸性粒细胞增多,伴有组织病理学上的全身症状以及坏死性血管炎、血管外肉芽肿和嗜酸性粒细胞组织浸润。我们报告一例4岁儿童,表现为急性肺炎且全身状况恶化。右前眼眶炎性假瘤活检显示坏死性血管炎、血管外上皮样肉芽肿和嗜酸性粒细胞组织浸润。这些是变应性肉芽肿性血管炎(Churg-Strauss综合征)的特征性改变。实验室检查结果的特点是血液嗜酸性粒细胞增多、IgE值升高以及存在抗中性粒细胞胞浆抗体(p-ANCA)。经胃肠外应用糖皮质激素后,局部和全身表现迅速消退。糖皮质激素剂量减少后,炎性假瘤出现两次加重。系统性血管炎综合征在儿童期罕见。儿童Churg-Strauss综合征的眼眶表现此前从未有过报道。

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