Lévêque L, Michiels C, Collet E, Jouve J L, Lorcerie B, Lambert D
Service de dermatologie, CHU Le Bocage, Dijon, France.
Rev Med Interne. 1998 May;19(5):334-7. doi: 10.1016/s0248-8663(98)80103-3.
The finding of eosinophilic ascites is unusual. It requires the search for the main etiology, i.e., parasitic or malignant disease, vasculitis or hypereosinophilic syndrome. The diagnosis of exclusion is either mucosal, muscular or serous eosinophilic gastroenteritis. This last type, the most unusual--as less than 50 cases have been documented until now--is associated with eosinophilic ascites.
We report a new case of serous eosinophilic gastroenteritis that occurred in a 23-year-old woman. This case was unusual because of its clinical history, as abdominal pain fits (along with the occurrence of ascites) were associated with urticaria fits. The lack of eosinophils in both the blood counts and the various digestive biopsies were unusual too. The disease evolution was favorable with corticosteroid therapy; however, a minimal dose of 8 mg/day was necessary to control the disease symptoms.
Because of its association with urticaria fits, this case emphasizes the need for differential diagnosis in patients with hypereosinophilic syndrome and food allergy.
嗜酸性腹水的发现并不常见。需要寻找主要病因,即寄生虫或恶性疾病、血管炎或嗜酸性粒细胞增多综合征。排除性诊断为黏膜性、肌性或浆液性嗜酸性粒细胞性胃肠炎。最后这种类型最为罕见——到目前为止记录在案的病例不足50例——与嗜酸性腹水有关。
我们报告了一例发生在一名23岁女性身上的浆液性嗜酸性粒细胞性胃肠炎新病例。该病例因其临床病史而不同寻常,因为腹痛发作(连同腹水的出现)与荨麻疹发作有关。血常规和各种消化活检中均未发现嗜酸性粒细胞也很不寻常。皮质类固醇治疗使疾病进展良好;然而,每天至少需要8毫克的剂量来控制疾病症状。
由于该病例与荨麻疹发作有关,强调了对嗜酸性粒细胞增多综合征和食物过敏患者进行鉴别诊断的必要性。