腹痛、多发血栓、嗜酸粒细胞增多综合征

Eosinophilia with abdominal pain and multiple thrombosis

以腹痛起病,伴多器官栓塞、嗜酸粒细胞增多病例骨髓检查嗜酸粒细胞比例增高。皮肤活检:嗜酸粒细胞浸润。抗中性粒细胞胞浆抗体阴性,FIP1L1/PDGFRα融合基因阴性的嗜酸粒细胞增多综合征,属骨髓增殖型疾病。骨髓活检及受累组织器官的病理检查对鉴别诊断有重要价值。需重视以腹痛为首发、伴血栓形成的类似病例,如有2个器官受累时需高度警惕该疾病及更多器官受累。

Objective Disussion of diagnosis and differential diagnosis of a case with abdominal pain,multiple thrombosis and agnogenic eosinophilia. Methods we report a case with abdominal pain,multiple thrombosis,agnogenic eosinophilia and review related literature. Results A 37-year-old male patient with abdominal pain,bilateral lower extremities rash,continuous eosinophilia. With complication of mild stenosis of superior mesenteric artery,pulmonary artery branch embolism and left popliteal artery thrombosis. Bone marrow biopsy revealed an increase in proportion of eosinophils.. Skin biopsy shown eosinophils infiltration. The blood sample was negative for antineutrophil cytoplasmic antibodies and FIP1L1 /PDGFRα fusion gene. Conclusion hypereosinophilic syndrome with negative F /P,one of myeloproliferative diseases. Biopsy and pathological results are significant to make a definitive diagnosis. We should pay more attention to the cases with the manifestation of abdominal pain and the complication of thrombosis,especially multiple organ affected.