儿童高嗜酸粒细胞增多症并发Loffler心内膜炎致死1例

A case of death in children with hypereosinophilia complicated with Loffler endocarditis

目的探讨儿童高嗜酸粒细胞增多症(hypereosinophilia,HE)并发Loffler心内膜炎的临床特征,旨在分析HE并发Loffler心内膜炎的病因、临床分期及预后。方法回顾性分析河北医科大学第二医院诊治的1例儿童高嗜酸粒细胞增多症并发Loffler心内膜炎的病例,分析其临床特点及发生原因及临床分期。结果本研究中该病例为少年男性,因间断腹痛腹泻40余天,呼吸困难10 d,进食极差3 d就诊,血常规提示为HE,超声提示Loffler心内膜炎,患儿存在严重心力衰竭,多脏器功能受累,经积极治疗后仍出现多脏器功能衰竭,最终因患者出现多脏器衰竭、心室颤动死亡。结论Loffler心内膜炎是HE的严重并发症,发病率低,临床罕见,早期干预可降低病死率。

Objective To investigate the clinical features of hypereosinophilia(HE)complicated with Loffler endocarditis in children,in order to analyze the etiology,clinical stage and prognosis of HE complicated with Loffler endocarditis.Methods A case of childhood hypereosinophilia complicated with Loffler endocarditis diagnosed and treated in the Second Hospital of Hebei Medical University was analyzed retrospectively,and its clinical characteristics,causes and clinical stages were analyzed.Results In this study,the patient was a young male.He had diarrhea for more than 40 days due to intermittent abdominal pain,dyspnea for 10 days,and poor food intake for 3 days.The blood routine showed that he was HE.The ultrasound showed Loffler endocarditis.The child had severe heart failure and multiple organ functions were involved.After active treatment,he still had multiple organ failure,and finally died of multiple organ failure and ventricular fibrillation.Conclusion Loffler endocarditis is a serious complication of HE,with low morbidity and rare clinical manifestations.Early intervention can reduce mortality.