嗜酸粒细胞性胃肠炎1例并文献复习

发布时间：2018-04-14 11:11

本文选题：嗜酸性粒细胞性胃肠炎 + 诊断　；参考：《兰州大学》2014年硕士论文

【摘要】：目的：探讨嗜酸粒细胞性胃肠炎的临床特点、诊断标准、鉴别诊断、治疗方法,以提高嗜酸粒细胞性胃肠炎的诊疗水平。方法：回顾性分析1例嗜酸粒细胞性胃肠炎患者的病例资料,结合复习相关文献进行总结。资料：一中年男性患者,进行性腹胀20天,入院前外院示白细胞及嗜酸性粒细胞增高,转氨酶升高,B超提示有腹水,行腹腔穿刺术,抽出血性腹水,离心涂片见多量嗜酸性粒细胞、红细胞,多量间皮细胞,给予对症治疗,症状无缓解,病情无好转。干预措施：行各项常规检查、胸部正位片、腹部CT、骨髓穿刺、腹腔穿刺、胃镜、肠镜等检查及病理学检查以明确诊断,并给予利尿、营养支持等对症治疗,诊断明确后给予泼尼松35mg/日,此后逐渐减量,5周后停用。结果：患者腹胀,病理学诊断：(食管)鳞状上皮增生伴非典型增生(轻度)；(胃窦)粘膜慢性炎症；(十二指肠)粘膜慢性炎症,有多量淋巴细胞浸润、浆细胞及少量中性粒细胞、嗜酸性粒细胞浸润；(结肠)慢性炎症(粘膜),少量嗜酸性粒细胞浸润。无胃肠道以外器官嗜酸性粒细胞浸润并除外其他引起嗜酸性粒细胞浸润的疾病。诊断为嗜酸粒细胞性胃肠炎。结论：对于腹水患者,先从常见病开始积极寻找原因,但不要忽略诸如“嗜酸粒细胞性胃肠炎”这类少见病、罕见病的可能。嗜酸粒细胞性胃肠炎常用激素治疗有效,要对该病提高认识,减少误诊及漏诊。
[Abstract]:Objective: to investigate the clinical features, diagnostic criteria, differential diagnosis and treatment of eosinophilic gastroenteritis (eosinophilic gastroenteritis).Methods: a case of eosinophilic gastroenteritis was analyzed retrospectively.Data: a middle-aged male patient with progressive abdominal distension for 20 days showed increased leukocyte and eosinophil and elevated aminotransferase before admission. B-mode ultrasound showed ascites, abdominal puncture was performed, and hemorrhagic ascites were drawn.Many eosinophils, erythrocytes and mesothelial cells were found in centrifuge smears.Intervention measures: routine examination, chest radiography, abdominal CT, bone marrow puncture, abdominal puncture, gastroscopy, enteroscopy and pathological examination were performed to make a definite diagnosis, and diuretic, nutritional support and other symptomatic treatment were given.Prednisone 35mg/ was given after diagnosis and was gradually reduced for 5 weeks.Results: in the patients with abdominal distension, pathological diagnosis showed that the squamous epithelium hyperplasia of the W (esophagus) accompanied with atypical hyperplasia (mild antrum), chronic inflammation of mucosal mucosa (duodenum), multiple lymphocytic infiltration, plasma cells and a small amount of neutrophils.Eosinophils infiltrate (colon) chronic inflammation (mucous membrane, a small amount of eosinophil infiltration.There is no eosinophil infiltration in organs outside the gastrointestinal tract except other diseases that cause eosinophil infiltration.Eosinophil gastroenteritis was diagnosed.Conclusion: for ascites patients, we should start with common diseases, but we should not ignore the possibility of rare diseases such as eosinophil gastroenteritis.Eosinophil gastroenteritis commonly used hormone treatment is effective, to improve the understanding of the disease, reduce misdiagnosis and missed diagnosis.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R57

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