临床儿科杂志
臨床兒科雜誌
림상인과잡지
2015年
6期
583-587
,共5页
朱碧溱%白海涛%吴谨准%许锦平
硃碧溱%白海濤%吳謹準%許錦平
주벽진%백해도%오근준%허금평
嗜酸性粒细胞%嗜酸细胞性胃肠炎%儿童
嗜痠性粒細胞%嗜痠細胞性胃腸炎%兒童
기산성립세포%기산세포성위장염%인동
eosinophils%eosinophilic gastroenteritis%child
目的：探讨儿童嗜酸细胞性胃肠炎的临床病理特点、治疗及预后。方法回顾性分析2例儿童嗜酸细胞性胃肠炎的临床表现、实验室检查、内镜病理结果、治疗经过及预后，并结合文献复习进行分析。结果2例患儿发病年龄分别为13岁、14岁，例1为男性患儿，以急性胰腺炎起病，例2为女性患儿，有食物过敏史，以不明原因腹水起病；2例患儿外周血嗜酸性粒细胞比例均显著升高(45.9%~64.8%)，血清IgE均明显升高(246~393 IU/ml)；2例患儿的骨髓细胞学检查均提示嗜酸性粒细胞比例增加；例1行胃镜、例2行胃镜和肠镜，内镜检查均提示胃肠道黏膜慢性炎症，例1病理活检提示十二指肠黏膜嗜酸性粒细胞浸润，例2病理活检提示胃肠道多处黏膜嗜酸性粒细胞浸润。2例患儿经食物回避、激素抗炎及抗过敏等综合治疗1周左右病情均明显缓解，复查血常规嗜酸性粒细胞均降至正常，例1随访24个月，例2随访2个月，病情均未见反复。结论儿童嗜酸细胞性胃肠炎临床表现及内镜所见缺乏特异性，不明原因的胃肠道症状伴外周血、骨髓嗜酸性粒细胞比例升高时应考虑到该病可能，腹水及内镜黏膜活检见嗜酸性粒细胞浸润，排除其他可能的疾病则可明确诊断。
目的：探討兒童嗜痠細胞性胃腸炎的臨床病理特點、治療及預後。方法迴顧性分析2例兒童嗜痠細胞性胃腸炎的臨床錶現、實驗室檢查、內鏡病理結果、治療經過及預後，併結閤文獻複習進行分析。結果2例患兒髮病年齡分彆為13歲、14歲，例1為男性患兒，以急性胰腺炎起病，例2為女性患兒，有食物過敏史，以不明原因腹水起病；2例患兒外週血嗜痠性粒細胞比例均顯著升高(45.9%~64.8%)，血清IgE均明顯升高(246~393 IU/ml)；2例患兒的骨髓細胞學檢查均提示嗜痠性粒細胞比例增加；例1行胃鏡、例2行胃鏡和腸鏡，內鏡檢查均提示胃腸道黏膜慢性炎癥，例1病理活檢提示十二指腸黏膜嗜痠性粒細胞浸潤，例2病理活檢提示胃腸道多處黏膜嗜痠性粒細胞浸潤。2例患兒經食物迴避、激素抗炎及抗過敏等綜閤治療1週左右病情均明顯緩解，複查血常規嗜痠性粒細胞均降至正常，例1隨訪24箇月，例2隨訪2箇月，病情均未見反複。結論兒童嗜痠細胞性胃腸炎臨床錶現及內鏡所見缺乏特異性，不明原因的胃腸道癥狀伴外週血、骨髓嗜痠性粒細胞比例升高時應攷慮到該病可能，腹水及內鏡黏膜活檢見嗜痠性粒細胞浸潤，排除其他可能的疾病則可明確診斷。
목적：탐토인동기산세포성위장염적림상병리특점、치료급예후。방법회고성분석2례인동기산세포성위장염적림상표현、실험실검사、내경병리결과、치료경과급예후，병결합문헌복습진행분석。결과2례환인발병년령분별위13세、14세，례1위남성환인，이급성이선염기병，례2위녀성환인，유식물과민사，이불명원인복수기병；2례환인외주혈기산성립세포비례균현저승고(45.9%~64.8%)，혈청IgE균명현승고(246~393 IU/ml)；2례환인적골수세포학검사균제시기산성립세포비례증가；례1행위경、례2행위경화장경，내경검사균제시위장도점막만성염증，례1병리활검제시십이지장점막기산성립세포침윤，례2병리활검제시위장도다처점막기산성립세포침윤。2례환인경식물회피、격소항염급항과민등종합치료1주좌우병정균명현완해，복사혈상규기산성립세포균강지정상，례1수방24개월，례2수방2개월，병정균미견반복。결론인동기산세포성위장염림상표현급내경소견결핍특이성，불명원인적위장도증상반외주혈、골수기산성립세포비례승고시응고필도해병가능，복수급내경점막활검견기산성립세포침윤，배제기타가능적질병칙가명학진단。
Objective To explore the clinical-pathological characteristics, treatment and prognosis of eosinophilic gastro-enteritis in children. Methods The data of clinical manifestation, laboratory examination, endoscopy, biopsy, management and prognosis from 2 pediatric patients with eosinophilic gastroenteritis were retrospectively analyzed. Related articles were reviewed. Results The age of two patients was 13 and 14 years old. Case 1 was male and had an onset with acute pancreatitis. Case 2 was female with a history of food allergy and had an onset with unexplained ascites. Both patients presented with signiifcantly increased peripheral eosinophil count (45.9%-64.8%) and serum IgE (246-393 IU/ml). Bone marrow cytology showed increased proportion of eosinophils in both patients. Gastroscopy was performed in case 1 while gastroscopy and colonoscopy endoscopy were performed in Case 2 and the results indicated eosinophilic inifltration in duodenum. Duodenal mucosa biopsy showed eosinophilic inifltration in case 1 while gastrointestinal pathology biopsy showed multiple mucosal eosinophil inifltration in case 2. After the therapy of food avoidance, steroid and anti-allergic drugs, both patients had complete remission 1 week later. Meanwhile the peripheral eosinophil count was decreased to normal. Case 1 was followed up for 24 months, and case 2 was followed up for 2 months. Both patients showed no evidence of relapse. Conclusions The clinical manifestation and endoscopic examination of eosinophilic gastroenteritis in children are protean and lack of speciifcity. Unexplained gastrointestinal symptoms accompanied with eosinophilia may suggest the possibility of eosinophilic gastroenteritis. Eosinophilic inifltration in ascites and gastrointestinal mucosa strongly indicate the di-agnosis of eosinophilic gastroenteritis. After exclusion of other possible diseases, the deifnite diagnosis can be made.
