儿童嗜酸细胞胃肠炎临床多样性分析

Clinical features of childhood eosinophilic gastroenteritis

目的分析儿童嗜酸细胞胃肠炎（EGE）的临床表现及治疗。方法回顾性分析2012年6月至2014年6月收治的10例EGE患儿的临床资料及治疗随访情况。结果 10例患儿中男6例,女4例,年龄9个月~14岁。学龄前及学龄儿童8例,临床表现腹痛（8例）、呕吐（4例）、腹泻（3例）、腹腔积液（3例）、皮疹（3例）、发热（2例）和低蛋白血症（2例）;婴幼儿2例,以腹泻、便血为主要表现。10例患儿外周血嗜酸细胞均升高,9例血Ig E升高,1例C反应蛋白明显升高。内镜检查显示黏膜充血、肿胀、红斑、糜烂。多点活检病理示,嗜酸细胞计数〉20个/HP。1例行腹腔镜探查后诊断明确。治疗包括规避饮食、奥美拉唑抑酸、抗过敏药等,其中4例患儿加用糖皮质激素治疗。随访半年~2年,10例中有1例病情反复。结论 EGE临床表现多样,内镜多点活检是诊断关键,腹腔镜探查有助于诊断;饮食治疗、糖皮质激素治疗效果较好。

Objective To analyze clinical manifestations and treatment of eosinophilic gastroenteritis （EGE） in children. Methods The clinical data of 10 children with EGE under the treatment from June 2014 to June 2012 were analyzed retrospectively. Results There were 10 children （6 males and 4 females） aged from 9 months to 14 years. Clin- ical symptoms of eight preschool and school age children included abdominal pain （8 cases）, vomiting （4 cases）, diarrhea （3 cases）, ascites （3 cases）, rash （3 cases）, fever （2 cases） and hypoalbuminemia （2 cases）. Clinical symptoms of two in- fant and toddler were diarrhea and hematochezia. Peripheral blood eosinophils were increased in 10 children. IgE was elevated in 9 children. One child had very high C-reactive protein. Endoscopic examination showed mucosal congestion, swelling, erythema, erosion. Multiple sites of biopsy showed eosinophil count〉 20/HP. One child was diagnosed by laparoscopic exploration. The treatment included diet avoidance, omeprazole, anti-allergic drug. Four children were treated with corticosteroids. All children had been followed up for 6 months to 2 years. One child had relapsed. Conclusion The clinical manifestations of EGE are various. Endoscopic biopsy is necessary for diagnosis. Laparoscopy also is helpful for diagnosis. Dietary and glucocorticoid therapy were effective