CAJ | 학술논문

回顾性分析我院收治的1例误诊为嗜酸粒细胞增多症的腹水型嗜酸粒细胞性胃肠炎(EG)患者的临床资料，并复习相关文献，探讨EG的临床特征、误诊原因及防范措施。患者以“腹胀半个月”入院，入院前腹部CT提示腹腔及盆腔积液，入院后查血常规示嗜酸性粒细胞计数及比例异常增多，腹水有核细胞涂片镜检可见大量嗜酸粒细胞。骨髓穿刺提示嗜酸粒细胞增多症；直肠黏膜组织活检镜下见黏膜内散在淋巴细胞、嗜酸粒细胞及中性粒细胞浸润。临床诊断嗜酸粒细胞增多症。患者转上级医院继续诊疗，上级医院修正诊断为腹水型EG。EG发病率低，外周血及骨髓检查类似嗜酸粒细胞增多症，临床医师应注意鉴别；临床对不明原因的腹水患者，应警惕浆膜型EG存在的可能性，以免误诊。
회고성분석아원수치적1례오진위기산립세포증다증적복수형기산립세포성위장염(EG)환자적림상자료，병복습상관문헌，탐토EG적림상특정、오진원인급방범조시。환자이“복창반개월”입원，입원전복부CT제시복강급분강적액，입원후사혈상규시기산성립세포계수급비례이상증다，복수유핵세포도편경검가견대량기산립세포。골수천자제시기산립세포증다증；직장점막조직활검경하견점막내산재림파세포、기산립세포급중성립세포침윤。림상진단기산립세포증다증。환자전상급의원계속진료，상급의원수정진단위복수형EG。EG발병솔저，외주혈급골수검사유사기산립세포증다증，림상의사응주의감별；림상대불명원인적복수환자，응경척장막형EG존재적가능성，이면오진。
The clinical data of 1 case of ascitic type eosinophilic gastroenteritis(EG) misdiagnosed as hypereosinophilia was retrospectively analyzed,and relevant literatures were reviewed.EG of clinical features,misdiagnosis reasons and preventive measures were explored.Patients were hospitalized for abdominal distension half a month.Abdominal CT in-dicated abdominal cavity and pelvic cavity hydrops before admission.After admission routine blood check indicated that eosinophil count and abnormal proportions were abnormal increase,ascites smear microscopy nucleated cells were found in a large number of eosinophils.Bone marrow biopsy indicated hypereosinophilia.The rectum mucosa biopsy under a microscope showed that,the mucous membrane in scattered lymphocytes jelly acid granulocyte and neutrophil infiltra-tion.Hypereosinophilia was diagnosed.Patients was turned to the superior hospital diagnosis and treatment continuely. The superior hospital correctted diagnosis for patients with ascites type acidophil gastroenteritis.EG had a low inci-dence,peripheral blood and bone marrow examination was similar to the disease of hypereosinophilia,clinicians should pay attention to identify.For the patients with unexplained ascitesin clinical,it should be vigilant the serosal type aci-dophilic granulocyte gastroenteritis possibility,in order to avoid misdiagnosis.