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A case of hypereosinophilic syndrome presenting with intractable gastric ulcers 被引量:2

A case of hypereosinophilic syndrome presenting with intractable gastric ulcers
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摘要 We report a rare case of hypereosinophilic syndrome (HES) presenting with intractable gastric ulcers. A 71-year-old man was admitted with epigastric pain. Initial endoscopic findings revealed multiple, active gastric ulcers in the gastric antrum. He underwent Helicobacterpylori (Hpylon) eradication therapy followed by proton pump inhibitor (PPI) therapy. However, follow- up endoscopy at 4, 6, 10 and 14 mo revealed persistent multiple gastric ulcers without significant improvement. The proportion of his eosinophil count increased to 43% (total count: 7903/mm3). Abdominal-pelvic and chest computed tomography scans showed multiple small nodules in the liver and both lungs. The endoscopic biopsy specimen taken from the gastric antrum revealed prominent eosinophilic infiltration, and the liver biopsy specimen also showed eosinophilic infiltration in the portal tract and sinusoid. A bone marrow biopsy disclosed eosinophilic hyperplasia as well as increased cellularity of 70%. The patient was finally diagnosed with HES involving the stomach, liver, lung, and bone marrow. When gastric ulcers do not improve despite H pylon eradication and prolonged PPI therapy, infiltrative gastric disorders such as HES should be considered. We report a rare case of hypereosinophilic syndrome(HES)presenting with intractable gastric ulcers.A 71-year-old man was admitted with epigastric pain.Initial endoscopic findings revealed multiple,active gastric ulcers in the gastric antrum.He underwent Helicobacter pylori(H pylori)eradication therapy followed by proton pump inhibitor(PPI)therapy.However,follow-up endoscopy at 4,6,10 and 14 mo revealed persistent multiple gastric ulcers without significant improvement.The proportion of his eosinophil count increased to 43%(total count:7903/mm 3).Abdominal-pelvic and chest computed tomography scans showed multiple small nodules in the liver and both lungs.The endoscopic biopsy specimen taken from the gastric antrum revealed prominent eosinophilic infiltration,and the liver biopsy specimen also showed eosinophilic infiltration in the portal tract and sinusoid.A bone marrow biopsy disclosed eosinophilic hyperplasia as well as increased cellularity of 70%.The patient was finally diagnosed with HES involving the stomach,liver,lung,and bone marrow.When gastric ulcers do not improve despite H pylori eradication and prolonged PPI therapy,infiltrative gastric disorders such as HES should be considered.
出处 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第48期6129-6133,共5页 世界胃肠病学杂志(英文版)
基金 Supported by Chung-Ang University College of Medicine
关键词 Gastric ulcer Hypereosinophilic syndrome 胃溃疡 顽固性 嗜酸粒细胞 嗜酸性粒细胞 综合征 扫描显示 质子泵抑制剂 价格指数
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  • 1[1]Straumann A.Idiopathic eosinophilic gastrointestinal diseases in adults.Best Pract Res Clin Gastroenterol 2008; 22:481-496
  • 2[2]Cello JP.Eosinophilic gastroenteritis--a complex disease entity.Am J Med 1979; 67:1097-1104
  • 3[3]Talley NJ,Shorter RG,Phillips SF,Zinsmeister AR.Eosinophilic gastroenteritis:a clinicopathological study of patients with disease of the mucosa,muscle layer,and subserosal tissues.Gut 1990; 31:54-58
  • 4[4]Khan S,Orenstein SR.Eosinophilic gastroenteritis.Gastroenterol Clin North Am 2008; 37:333-348
  • 5[5]Klein NC,Hargrove RL,Sleisenger MH,Jeffries GH.Eosinophilic gastroenteritis.Medicine (Baltimore) 1970; 49:299-319
  • 6[6]Gorrepati N,Desai H,Fox S,Amin M,Stecevic V,Desai T.An eight-year study of 30 consecutive patients with eosinophilic gastroenteritis in one gastroenterology practice:eosinophilic gastroenteritis is more common than previously appreciated and may not necessarily require corticosteroid therapy.Gastroenterology 2007; 132:A610 (Abstract)
  • 7[7]Lowichik A,Weinberg AG.A quantitative evaluation of mucosal eosinophils in the pediatric gastrointestinal tract.Mod Pathol 1996; 9:110-114
  • 8[8]DeBrosse CW,Case JW,Putnam PE,Collins MH,Rothenberg ME.Quantity and distribution of eosinophils in the gastrointestinal tract of children.Pediatr Dev Pathol 2006; 9:210-218
  • 9[9]Freeman HJ.Histologic evaluation or gastric biopsies for diagnosis and treatment in eosinophilic gastroenteritis.Can J Gastroenterol 1993; 7:343-348
  • 10[10]Bennett RA,Whitelock T 3rd,Kelley JL Jr.Eosinophilic gastroenteritis,gluten enteropathy,and dermatitis herpetiformis.Am J Dig Dis 1974; 19:1154-1161

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