Eosinophilic esophagitis （EE） is the most frequent con- dition found in a group of gastrointestinal disorders called eosinophilic gastrointestinal diseases. The hypo- thetical pathophysiological mechanism is related...Eosinophilic esophagitis （EE） is the most frequent con- dition found in a group of gastrointestinal disorders called eosinophilic gastrointestinal diseases. The hypo- thetical pathophysiological mechanism is related to a hypersensitivity reaction. Gastroesophageal reflux dis- ease-like complaints not ameliorated by acid blockade or occasional symptoms of dysphagia or food impac- tion are likely presentations of EE. Due to its unclear pathogenesis and unspecific symptoms, it is difficult to diagnose EE without a strong suspicion. Although histo- togical criteria are necessary to diagnosis EE, there are some characteristic endoscopic features. We present the case of a healthy 55-year-old woman with dyspha- gia and several episodes of esophageal food impaction over the last six months. This case report stresses the most distinguishing endoscopic findings-mucosa rings, white exudative plaques and linear furrows-that can help in the prompt recognition of this condition.展开更多
文摘目的从呼吸系统疾病的角度分析和认识ANCA相关性血管炎(ANCA-associated Vasculitis,AAV)。方法回顾性分析我院确诊的10例以呼吸系统病变为主要表现的AAV患者的临床资料,对患者的临床表现、实验室检查、影像学表现以及其他特殊检查结果进行汇总分析,采用五因子评分系统评估预后。结果本组患者显微镜下多血管炎(microscopic polyangiitis,MPA)7例,肉芽肿性多血管炎(granulomatosis with polyangiitis,GPA)2例,嗜酸性肉芽肿性血管炎(eosinophilic granulomatosis with polyangiitis,EGPA)1例,男性3例,女性7例。咳嗽咳痰咯血及呼吸困难是AAV最常见的呼吸系统症状,部分患者合并其他系统特别是肾脏累及。实验室检查MPA均有p ANCA和MPO-ANCA阳性,GPA和EGPA患者有c ANCA和PR3-ANCA阳性,7例患者有CRP升高(82.18±48.67mg/L),10例患者均有血沉升高(62.9±13.5mm/h);仅有4例患者出现肌酐轻度升高(139±29.3umol/L),3例患者淋巴细胞总数降低,提示继发感染风险大,预后欠佳。影像学表现多表现为双肺磨玻璃斑片影、间质改变以及蜂窝肺表现,对诊断具有提示作用。肺功能检查表现为限制性通气功能障碍,部分患者出现肺动脉高压。结论肺部是AAV的常见累及器官,部分患者以肺部病变为主要表现,呼吸科医生应加强对AAV的认识,提高诊断率,减少误诊和漏诊。
文摘Eosinophilic esophagitis （EE） is the most frequent con- dition found in a group of gastrointestinal disorders called eosinophilic gastrointestinal diseases. The hypo- thetical pathophysiological mechanism is related to a hypersensitivity reaction. Gastroesophageal reflux dis- ease-like complaints not ameliorated by acid blockade or occasional symptoms of dysphagia or food impac- tion are likely presentations of EE. Due to its unclear pathogenesis and unspecific symptoms, it is difficult to diagnose EE without a strong suspicion. Although histo- togical criteria are necessary to diagnosis EE, there are some characteristic endoscopic features. We present the case of a healthy 55-year-old woman with dyspha- gia and several episodes of esophageal food impaction over the last six months. This case report stresses the most distinguishing endoscopic findings-mucosa rings, white exudative plaques and linear furrows-that can help in the prompt recognition of this condition.
