Ranque S, Candolfi E, Himy R
Institut de Parasitologie, Pathologie tropicale, Strasbourg.
Presse Med. 1998 Feb 28;27(8):370-5.
Helminth infestation of the digestive tract or organ tissues is a common and curable cause of high eosinophil counts. Parasite infestation should be the number one suspect in patients with hypereosinophilia.
Clinical signs and epidemiology are suggestive. If the patient has travelled to the tropics, one should consider both exotic and cosmopolite parasites.
The causal agent can sometimes be identified by direct examination of tissue samples, depending on the localization. In practice however identification may be a difficult task when the level of infestation is low or the helminth is in a larval stage. The epidemiological situation, clinical features and results of serology tests must all be considered for diagnosis.
ANTIHELMINTH TREATMENT (TEST): Clinical improvement after treatment can be a criteria for positive diagnosis. Normal eosinophil counts followed later by normal serology confirms the diagnosis.
消化道或器官组织的蠕虫感染是嗜酸性粒细胞计数升高的常见且可治愈的原因。寄生虫感染应是嗜酸性粒细胞增多症患者的首要怀疑对象。
临床体征和流行病学情况具有提示作用。如果患者去过热带地区，应考虑外来寄生虫和世界性分布的寄生虫。
根据感染部位，有时可通过直接检查组织样本确定病原体。然而在实际操作中，当感染程度较低或蠕虫处于幼虫阶段时，鉴定可能是一项艰巨的任务。诊断必须综合考虑流行病学情况、临床特征和血清学检查结果。
抗蠕虫治疗（试验性）：治疗后临床症状改善可作为阳性诊断的标准。随后嗜酸性粒细胞计数恢复正常且血清学检查结果正常可确诊。
