第3例：阵发性心慌-肝脾肿大-腹水  

Palpitation-hepatosplenomegalyascites： a case report and literature review

作　　者：赵建秋[1] 卢向东[1] 张志广[1] 江勇[1] 

机构地区：[1]天津医科大学第二医院消化科,300211

出　　处：《中华老年医学杂志》2012年第8期726-728,共3页Chinese Journal of Geriatrics

摘　　要：诊治难点：患者有阵发心慌、面色潮红、血压下降、腹泻、肝脾肿大及腹水等症状。腹水常见病因为肝硬化、肿瘤、结核等，系统性肥大细胞增多症为造成腹水的少见疾病之一。This report presented a case of 62-year-old woman who was admitted to our hospital for ＂cirrosis＂, but she had a variety of clinical manifestations, such as abdominal distension, diarrhea, ascites, hepatosplenomegaly, anemia, palpitation, flushing, low blood pressure, arrhythmia and so on. Upper gastrointestinal endoscopy showed thicken mucosa at gastric fundus. Colonoscopy revealed nodular, pseudopolypoid. Ascitic fluid test suggested a transudate. Endoscopic abnormal mucosa biopsy showed chronic inflammation. Many mast cells were seen in bone marrow and liver biopsies, and liver tissue immunophenotype was CDl17, and CD68. Thus the patient＇s diagnosis was systemic mastocytosis. It is rare that a patient only has the gastrointestinal tract symptoms complicated with ascites without skin lesion. The goal for treatment was to reduce hypersecretion of mast cells.

关 键 词：阵发性心慌 肝脾肿大 腹水 系统性肥大细胞增多症 血压下降 常见病因 少见疾病 肝硬化 

分 类 号：R597[医药卫生—内科学]