摘要
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。
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 mueosa biopsy under a microscope showed that,the mucous membrane in scattered lymphocytes jelly acid granulocyte and neutrophil infihra- tion.Hypereosinophilia was diagnosed.Patients was tamed to the superior hospital diagnosis and treatment continuely. The superior hospital correctted diagnosis for patients with ascites type acidophil gastroenteritis.EG had a low incidence,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 acidophilic granulocyte gastroenteritis possibility,in order to avoid misdiagnosis.
出处
《中国当代医药》
2015年第21期165-167,共3页
China Modern Medicine
