以腹水为首发症状的嗜酸粒细胞性胃肠炎1例并文献复习

A Case of Eosinophilic Gastroenteritis with Ascites as the First Symptom and Literature Review

摘要: 目的：分析嗜酸粒细胞性胃肠炎(eosinophilic gastroenteritis, EG)临床特征，为诊断和治疗提供思路。方法：本研究通过对本院诊断的1例嗜酸粒细胞胃肠炎浆膜型病例行回顾分析并随访，患者男，39岁，因“腹胀伴腹泻2周”入院。行全腹CT示腹腔积液，血常规示嗜酸粒细胞计数7.47 × 10⁹/L。胃镜病理：胃和十二指肠球部每高倍镜视野内嗜酸粒细胞个数3~14个。腹水病理：镜下见较多量嗜酸粒细胞及少量中性粒细胞。予大剂量激素冲击及小剂量维持治疗。结果：患者经治疗后随访未再出现复发。结论：嗜酸粒细胞性胃肠炎是一种少见的嗜酸粒细胞(eosinophilic granulocyte, EoS)增多的胃肠疾病，其侵及浆膜层时可表现为大量嗜酸性腹水，其临床表现多样，患者多伴随过敏史，糖皮质激素治疗有效。

Abstract: Objective: To analyze the clinical characteristics of eosinophilic gastroenteritis and provide ideas for diagnosis and treatment. Methods: In this study, a case of serosal eosinophilic gastroenteritis diagnosed in our hospital was retrospectively analyzed and followed up. The patient was 39 years old and was admitted to the hospital with “abdominal distension and diarrhea for 2 weeks”. A CT scan of the whole abdomen showed fluid in the abdominal cavity, and a routine blood test showed an eosinophil count of 7.47 × 10⁹/L. Gastroscopy pathology: The number of eosinophils per high-power field of the stomach and duodenal bulb is 3~14. Ascites pathology: More eosinophils and a few neutrophils were seen under the microscope. Give high-dose hormone shock and low-dose maintenance treatment. Results: The patient did not relapse after follow-up after treatment. Conclusion: Eosinophilic gastroenteritis (eosinophilic gastroenteritis, EG) is a rare gastrointestinal disease with increased eosinophilic granulocyte (EoS), which can manifest as a large amount of eosinophilia when it invades the serosal layer. Its clinical manifestations are diverse, most patients are accompanied by a history of allergies, and glucocorticoid therapy is effective.