EOSINOPHILIC GASTROENTERITIS - A CLINICOPATHOLOGICAL STUDY OF PATIENTS WITH DISEASE OF THE MUCOSA, MUSCLE LAYER, AND SUBSEROSAL TISSUES
EOSINOPHILIC GASTROENTERITIS - A CLINICOPATHOLOGICAL STUDY OF PATIENTS WITH DISEASE OF THE MUCOSA, MUSCLE LAYER, AND SUBSEROSAL TISSUES
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DOI：
10.1136/gut.31.1.54
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发表时间：
1990-01-01
期刊：
影响因子：
24.5
通讯作者：
ZINSMEISTER, AR
中科院分区：
文献类型：
--
作者：
TALLEY, NJ;SHORTER, RG;ZINSMEISTER, AR
本研究的目的是评估嗜酸性粒细胞性胃肠炎的临床病理学谱并确定诊断中可能存在的困难。所有诊断为嗜酸性粒细胞性胃肠炎的患者（定义为存在胃肠道症状和肠道嗜酸性粒细胞浸润（38 例），或放射学诊断为外周嗜酸性粒细胞增多（2 例））均从 Mayo Clinic 记录中确定；没有任何证据表明存在肠外疾病。根据 Klein 分类，患者被分为三组：主要粘膜疾病（23 例）、肌肉疾病（12 例）或浆膜下疾病（5 例）。用于比较的第四组患者（10 名）有腹部症状和无法解释的外周嗜酸性粒细胞增多，但没有证实肠道有嗜酸性粒细胞浸润。研究发现，有20至40名嗜酸性粒细胞性胃肠炎患者报告有过敏史。 40 名患者中有 9 名不存在外周嗜酸性粒细胞增多。患有浆膜下疾病的患者在表现（腹胀、腹水）、较高的嗜酸性粒细胞计数以及对类固醇治疗的显着反应方面与其他组不同。除此之外，患者在人口统计学因素、症状（腹痛、恶心、体重减轻、腹泻）和实验室参数方面相似。 40 名患者中有 10 名的 ESR 适度升高。该疾病可能影响胃肠道的任何区域；一名患者的食管和两名患者的结肠中记录到嗜酸性粒细胞浸润。内窥镜活检在 40 例中有 5 例漏掉了诊断，可能是因为疾病不完整。即使没有外周嗜酸性粒细胞增多，在不明原因胃肠道症状的鉴别诊断中也应考虑嗜酸性粒细胞性胃肠炎。
The aim of this study was to evaluate the clinicopathological spectrum of eosinophilic gastroenteritis and identify possible difficulties in establishing the diagnosis. All patients with a diagnosis of eosinophilic gastroenteritis, defined by the presence of gastrointestinal symptoms and eosinophilic infiltration of the gut (38), or a radiological diagnosis with peripheral eosinophilia (two), were identified from the Mayo Clinic records; in none was there evidence of extraintestinal disease. Patients were divided into three groups according to the Klein classification: predominant mucosal (23), muscular (12), or subserosal disease (five). A fourth group of patients (10) for comparison had abdominal symptoms and unexplained peripheral eosinophilia but no proven eosinophilic infiltration of the gut. It was found that a history of allergy was reported by 20 to 40 patients with eosinophilic gastroenteritis. Peripheral eosinophilia was absent in nine of 40. The patients with subserosal disease were distinct from the other groups in presentation (abdominal bloating, ascites), higher eosinophil counts and in their dramatic responses to steroid therapy. Otherwise the patients were similar regarding demographic factors, presenting symptoms (abdominal pain, nausea, weight loss, diarrhoea), and laboratory parameters. The ESR was moderately raised in 10 of 40 patients. The disease may affect any area of the gastrointestinal tract; eosinophilic infiltration was documented in the oesophagus in one patient and in the colon in two cases. Endoscopic biopsies missed the diagnoses in five of 40 presumably because of patchy disease. Eosinophilic gastroenteritis should be considered in the differential diagnosis of unexplained gastrointestinal symptoms even in the absence of peripheral eosinophilia.