17岁男童反复腹痛、腹腔积液伴嗜酸性粒细胞增多

Recurrent abdominal pain,peritoneal effusion,and eosinophilia in a boy aged 17 years

17岁男童,因腹痛、腹泻伴嗜酸性粒细胞增多3年,加重3 d入院。3年前患儿因进食“老酸奶”后出现腹痛、腹泻,彩超示大量腹腔积液,血常规、骨髓细胞形态学检查、腹水组织学检查可见大量嗜酸性粒细胞;3 d前因腹痛、腹泻再次入院,胃肠镜检查胃角见嗜酸性粒细胞浸润,确诊为嗜酸细胞性胃肠疾病(嗜酸细胞性胃肠炎),给予糖皮质激素及饮食规避治疗后好转,随访1年未反复。对于因腹痛、腹泻等消化道症状就诊的患儿,如伴外周血嗜酸性粒细胞增多,需考虑嗜酸细胞性胃肠疾病的可能,内镜活检胃肠道组织中见嗜酸性粒细胞浸润且计数异常为诊断的关键。

A boy,aged 17 years,was admitted again due to abdominal pain,diarrhea,and eosinophilia for 3 years,which worsened for 3 days.Three years ago,the boy suffered from abdominal pain and diarrhea after eating yogurt;color Doppler ultrasound showed a large amount of peritoneal effusion,and routine blood test,bone marrow cell morphology,and ascites histological examination showed a large number of eosinophils.Three days ago,he was admitted again due to abdominal pain and diarrhea.The gastrointestinal endoscopy showed eosinophil infiltration in the angle of stomach.The boy was diagnosed with eosinophilic gastrointestinal disease(eosinophilic gastroenteritis).He was improved after the treatment with glucocorticoids and dietary avoidance,and no recurrence was observed during the one year follow-up.It is concluded that for children who attend the hospital due to gastrointestinal symptoms such as abdominal pain and diarrhea,if there is an increase in peripheral blood eosinophils,it is necessary to consider the possibility of eosinophilic gastrointestinal disease,and eosinophil infiltration and abnormal eosinophil count in gastrointestinal tissue based on endoscopic biopsy may be the key to diagnosis.