摘要
目的探讨嗜酸性粒细胞性胃肠炎(eosinophilic gastroenteritis,EG)的误诊原因、临床特点、诊断要点及治疗、预后。方法回顾性分析23例被误诊的EG患者的临床资料。结果 23例患者入院前被误诊为结核性腹膜炎8例,急性胃肠炎5例,恶性肿瘤3例,不全性肠梗阻3例,肠易激综合征2例,消化性溃疡1例,慢性胰腺炎1例。腹痛为最常见的临床表现。外周血嗜酸性粒细胞计数均升高,内镜下主要表现为黏膜充血水肿、糜烂,病理检查及骨髓、腹水检查均见嗜酸性粒细胞。激素治疗可在1周内迅速缓解症状,并使嗜酸性粒细胞恢复正常。病情可有反复,且预后良好。结论 EG临床表现多种多样,无特异性,常易误诊或漏诊。外周血嗜酸性粒细胞绝对值计数、组织活检及骨髓象、腹水见嗜酸性粒细胞增多是诊断的关键。
Objective To investigate the misdiagnosis, characteristics, diagnosis, treatment and prognosis of eosinophilic gastroenteritis （EG）. Methods Clinical data of 23 misdiagnosed EG pa- tients were retrospectively analyzed. Results Among the 23 EG patients,8 were misdiagnosed as tuberculous peritonitis, 5 as acute gastroenteritis, 3 as malignant tumor,3 as incomplete intestinal obstruction, 2 as irritable bowel syndrome, 1 as peptic ulcer, and 1 as chronic pancreatitis. Abdom- inal pain was the most common clinical presentation. The peripheral eosinophil count increased in all EG patients. Endoscopic examination showed the edema and erosion. Eosinophilic infiltration was confirmed by biopsy. Furthermore, eosinophils were found in ascitic fluid and marrow. Steroid therapy could relieve symptoms and decrease eosinophilia within a week. EG recurrence might oc- cur,but prognosis was good. Conclusion Clinical presentations of EG are nonspecific and the di- agnosis of EG is easily incorrect and missed. The increase in peripheral eosin0phil counts, biopsy and eosinophilia in marrow and ascites are keys to the diagnosis of EG.
出处
《南昌大学学报（医学版）》
CAS
2013年第7期30-33,共4页
Journal of Nanchang University：Medical Sciences
关键词
嗜酸性粒细胞性胃肠炎
误诊
临床表现
诊断
治疗
eosinophilic gastroenteritis
misdiagnosisclinical manifestation
diagnosis
treatment
