嗜伊紅白血球胃腸炎－1病例報告

Eosinophilic Gastroenteritis

周百達(P. T. Chou) ； 沈德昌(D. C. Shen) ； 程東照(T. C. Chen) ； 方名熹(M. S. Fong) ； 何逸僊(Y. S. Ho)

《Journal of Medical Sciences》 5卷4期 (1984/10) Pp. 2085-2092

摘要

嗜伊紅白血球胃腸炎，好侵犯胃及小腸。本病例臨床症狀有嘔吐、腹痛及腹瀉，末梢血液有明顯的嗜伊紅白血球增高，大便檢查有潛血反應及許多Charcot-Leyden結晶體，上腸胃道、小腸及大腸放射線檢查皆正常，病理切片顯示嗜伊紅白血球侵犯胃、十二指腸、空腸、迴腸、盲腸及直腸。病人無過敏病史，免疫檢查亦正常，經類固醇長期治療，效果良好，未再復發，因國內此類病例甚少，故提出報告。

並列摘要

Eosinophilic gastroenteritis was first described by Kaijser in 1937. Since then more than 100 cases have been reported describing patients with gastrointestinal symptoms, peripheral eosinophilia and mature eosinophils infiltration in the gastrointestinal tissues. The gastric antrum and the proximal small intestine are the sites most commonly involved, but, involvement of the esophagus, ileocecal region, and extraintestinal sites such as pancreas and urinary bladder has been reported recently. A woman without history of atopic disorder of food allergy recently treated in our department was investigated because of symptoms of epigastric discomfort, diarrhea and loss of body weight. The stool examination showed mild steatorrhea, many Charcot-Leyden crystals and occult blood (+~+ + +). The CBC showed eosinophilia (up to 75%). The ESR was 20 mm/hr. The serum iron was 65 ug% and TIBC 306 ug%. The SMA-12 showed hypoproteinemia (5.3gm%) and hypoalbuminemia (2.3 gm%). The data of immunological studies including IgG, IgM, IgA, IgE, total lymphocyte count(16% B-cell, 50% T-cell), and stimulation index (PHA, PWM & Con-A) were within normal limits. The roentgenograms of upper gastrointestinal series, small intestine and barium enema all showed negative. The gastroscopic examination showed multiple erosions and two areas of erythema over the gastric body and antrum, the duodenum and proximal jejunum were negative. The colonofiberscopic examination showed mild erythema over the terminal ileum, cecum and rectum. Microsopic examination of the biopsy from the stomach, duodenum, Jejunum, terminal ileum, cecum and recto-anal junction revealed eosinopilic infiltration. The treatment with prednisolone rapidly reduced the clinical and hematological abnormalities. The patient was thought to have idiopathic eosinophilic gastroenteritis, not due to food allergy.

並列關鍵字

Eosinophilic Gastroenteritis