腹膜透析伴嗜酸性粒细胞性胃肠炎一例报告

Peritoneal dialysis accompanied by eosinophilic gastroenteritis: a case report

腹膜透析合并嗜酸性粒细胞性胃肠炎(EG)在临床工作中极其罕见,极易漏诊与误诊。该文报道1例慢性肾衰竭、尿毒症期患者,行腹膜透析治疗后反复出现腹部不适,伴有腹泻,予暂停腹膜透析,改行血液透析治疗后,上述症状停止。当再次行腹膜透析治疗,患者腹部不适及腹泻的症状再发,予抗感染、止泻等治疗效果差,肠镜肠黏膜活组织检查和透析液细胞学检查均发现嗜酸性粒细胞浸润,确诊EG后予肾上腺皮质激素治疗,患者症状改善明显,好转出院。该例提示,虽然腹膜透析合并EG是极其罕见的疾病,但给予正确治疗,预后较好。

Peritoneal dialysis accompanied by eosinophilic gastroenteritis（ EG） is rarely encountered in clinical practice,which is likely to be missed diagnosis and misdiagnosed. In this paper,we reported one case of end-stage chronic renal failure,who presented with repeated abdominal discomfort after peritoneal dialysis accompanied by diarrhea. Subsequently,peritoneal dialysis was suspended and switched to hemodialysis,and these symptoms were alleviated. Upon the secondary peritoneal dialysis,the symptoms of abdominal discomfort and diarrhea recurred. Anti-infection and anti-diarrhea treatment yielded poor clinical efficacy. The diagnosis of eosinophilic gastroenteritis was confirmed by infiltration of eosinophilis in intestinal mucosa and dialysate. After adrenocortical hormone therapy,these symptoms were significantly mitigated,and the patient was discharged. This case illustrates that peritoneal dialysis accompanied by EG is an extremely rare disease. Efficacious treatment can yield favorable clinical prognosis.