临床儿科杂志 ›› 2020, Vol. 38 ›› Issue (5): 390-.doi: 10.3969/j.issn.1000-3606.2020.05.019

• 综合报道 • 上一篇    下一篇

儿童浆膜病变型嗜酸性粒细胞性胃肠炎1 例并文献复习

王洪丽 1, 耿岚岚 1, 龚四堂 1, 李慧雯 1, 陈佩瑜 1, 谢静 1, 吴强 2   

  1. 广州医科大学附属广州市妇女儿童医疗中心1.消化内科,2.胃肠外科(广东广州 510120)
  • 出版日期:2020-05-15 发布日期:2020-06-02
  • 通讯作者: 耿岚岚 电子信箱:genlan_2001@hotmail.com

Clinical analysis of a case of serosal type of eosinophilic gastroenteritis and review of literature

WANG Hongli1, GENG Lanlan1, GONG Sitang1, LI Huiwen1, CHEN Peiyu1, XIE Jing1, Wu Qiang2   

  1. 1. Department of Gastroenterology; 2. Department of Gastrointestinal Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510120, Guangdong, China
  • Online:2020-05-15 Published:2020-06-02

摘要: 目的 探讨儿童浆膜病变型嗜酸性粒细胞性胃肠炎(eosinophilic gastroenteritis,EGE)的诊断、治疗和预后。 方法 回顾性分析1例浆膜病变型EGE患儿的临床资料,同时复习国内外近10年关于浆膜病变型EGE的文献。结果 患 儿,男, 5岁起病,以腹痛、腹胀为主要表现,外周血和骨髓嗜酸性粒细胞(eosinophils,EOS)计数明显增高,腹水中可见大 量EOS。腹腔镜下取肠管浆膜层多点活检可见大量EOS浸润,需长期小剂量激素维持。文献检索国内外关于浆膜病变型 EGE文献共16篇,浆膜病变型EGE患儿多出现腹水,激素治疗比较敏感,激素减量或停药后病情易反复,部分患儿需小剂 量长期维持。 结论 浆膜病变型EGE临床表现中腹水多见,浆膜层组织中EOS增多是病理诊断的关键,激素治疗比较敏 感,激素减量或停药后病情易反复,部分患儿需小剂量激素长期维持。

关键词:  嗜酸性粒细胞性胃肠炎; 浆膜型; 儿童

Abstract:  Objective To explore the clinical characteristics, diagnosis, treatment and prognosis of serous eosinophilic gastroenteritis (EGE) in children, and to improve diagnosis and therapy of it. Methods The data of clinical manifestation, laboratory examination, endoscopy, biopsy, management and prognosis from one boy with serous type of EGE were retrospectively analyzed. The Chinese databases and PubMed databases were searched for serous type of EGE in the last ten years for literature review. Results A 16-years-old boy with serosal type of EGE show nonspecific gastrointestinal symptoms such as abdominal pain and abdominal distension. EOS counts in peripheral blood and bone marrow were significantly increased. A large number of EOS were found in his ascites. A large number of EOS can be seen in the serous layer of the intestine from laparoscopic sampling. This boy needs long-term and low dose hormone maintenance. There are 16 articles about serous disease type of EGE found in the domestic and foreign databases. Ascites is the most commonly seen symptom for serous type of EGE. Hormone therapy is sensitive, and the clinical symptoms reappear easily along with the hormone reduction or withdrawal. Some children need longterm maintenance of low dose glucocorticoid. Conclusions Ascites is the most commonly seen symptom for serous type of EGE. Increased EOS in serosal tissue is the key for pathological diagnosis. Hormone therapy is sensitive, and the clinical symptoms reappear easily along with hormone reduction or withdrawal. Some children need long-term maintenance of low dose glucocorticoid.

Key words: eosinophilic gastroenteroenteritis; serous; child