临床儿科杂志 ›› 2016, Vol. 34 ›› Issue (1): 40-.doi: 10.3969 j.issn.1000-3606.2016.01.011

• 综合报道 • 上一篇    下一篇

原发性小肠淋巴管扩张症1 例报告并文献复习

赵雪梅, 邓思燕, 朱渝, 万朝敏   

  1. 四川大学华西第二医院感染儿科(四川成都 610041)
  • 收稿日期:2016-01-15 出版日期:2016-01-15 发布日期:2016-01-15
  • 通讯作者: 邓思燕 E-mail:dengsiyan@126.com

Primary intestinal lymphangiectasia: one case report and literature review

 ZHAO Xuemei, DENG Siyan, ZHU Yu, WAN Chaomin   

  1. West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan, China
  • Received:2016-01-15 Online:2016-01-15 Published:2016-01-15

摘要:  目的 探讨原发性小肠淋巴管扩张症(PIL)的临床表现及预后。方法 回顾性分析1 例PIL 患儿的临床资料,并复习相关文献。结果 患儿,女,5 岁,生后逐渐出现进行性加重的腹胀、腹泻、全身水肿。实验室检查显示低白蛋白血症、淋巴细胞减少症、低丙种球蛋白血症。胃镜检查见十二指肠空肠弥漫的白色斑点,活检证实黏膜间质淋巴管扩张。确诊后予静脉输注白蛋白、利尿和调整饮食等治疗,病情很快缓解出院。结论 原发性小肠淋巴管扩张症是一种罕见的蛋白丢失性肠病,诊断主要依靠小肠病理活检。早期诊断、及时饮食干预及肠外营养支持等可以很好改善患儿的症状和体征。

Abstract:  Objective To explore the clinical features and prognosis of primary intestinal lymphangiectasia (PIL). Methods The clinical data from one pediatric patient with PIL was retrospectively analyzed. The relevant literatures were reviewed. Results The 5-year-old female patient gradually presented with progressive abdominal distension, diarrhea, and general edema after birth. Laboratory tests revealed hypoalbuminemia, lymphocytopenia, and hypogammaglobulinemia. Gastroscopy showed diffuse white spots in duodenum and jejunum. The histopathology confirmed greatly dilated lymphatics in interstitial mucosa. After diagnosis, the intravenous infusion of albumin, diuretic, and dietary adjustment were administrated. The patient quickly relieved and was discharged. Conclusions PIL is a rare protein-losing enteropathy. The diagnosis of PIL mainly relies on small intestine biopsy. Early diagnosis, early dietary intervention and parenteral nutrition support could improve the symptoms and signs.