第3例：阵发性心慌-肝脾肿大-腹水

Palpitation-hepatosplenomegalyascites： a case report and literature review

诊治难点：患者有阵发心慌、面色潮红、血压下降、腹泻、肝脾肿大及腹水等症状。腹水常见病因为肝硬化、肿瘤、结核等，系统性肥大细胞增多症为造成腹水的少见疾病之一。

This report presented a case of 62-year-old woman who was admitted to our hospital for ＂cirrosis＂, but she had a variety of clinical manifestations, such as abdominal distension, diarrhea, ascites, hepatosplenomegaly, anemia, palpitation, flushing, low blood pressure, arrhythmia and so on. Upper gastrointestinal endoscopy showed thicken mucosa at gastric fundus. Colonoscopy revealed nodular, pseudopolypoid. Ascitic fluid test suggested a transudate. Endoscopic abnormal mucosa biopsy showed chronic inflammation. Many mast cells were seen in bone marrow and liver biopsies, and liver tissue immunophenotype was CDl17, and CD68. Thus the patient＇s diagnosis was systemic mastocytosis. It is rare that a patient only has the gastrointestinal tract symptoms complicated with ascites without skin lesion. The goal for treatment was to reduce hypersecretion of mast cells.