木村病26例诊治体会  

Diagnosis and Treatment of 26 Patients with Kimura′s Disease

作　　者：章波[1] 袁雁[1] 付斌[1] 

机构地区：[1]浙江省嘉兴市第二医院,314000

出　　处：《中国全科医学》2012年第32期3774-3775,共2页Chinese General Practice

摘　　要：目的探讨木村病(KD)的临床表现、诊断及治疗方法,以提高临床医生对该病的认识,减少误诊。方法回顾性分析我院2005—2011年收治的26例KD患者的临床表现、实验室检查结果、诊治方法及随访情况。结果 26例患者均以无痛性皮下肿块为首发症状来诊,其中19例外周血嗜酸粒细胞及IgE升高。由于症状缺乏特异性,KD患者初诊均被误诊,最终26例均行肿块切除行病理检查,其结果均符合KD典型病理表现,遂明确诊断。结论 KD是一种罕见的慢性免疫炎性疾病,临床表现缺乏特异性,易误诊,确诊有赖于病理活检。相对特异的实验室检查结果有:外周血嗜酸粒细胞升高、血清IgE升高等。部分患者可伴有肾脏损害。治疗方法主要有手术切除、糖皮质激素治疗、放射治疗。Objective To investigate the clinical features,diagnosis and treatment of Kimura′s disease（KD） in order to improve the understanding and to reduce misdiagnosis of this disease.Methods Clinical features,laboratory data and following up of 26 KD patients admitted to our hospital from 2005 to 2011 were retrospectively analyzed.Results 26 cases all initially demonstrated subcutaneous tumor,among which 19 cases had increased serum IgE and eosinophilic granulocyte in peripheral blood.All the KD patients were misdiagnosed due to the lack of symptom specificity.Tumor resection and biopsies were performed in the 26 cases and the biopsy results were consistent with typical symptoms of KD.Conclusion KD is a rarely seen chronic immune-inflammatory disease and is tend to be misdiagnosed due to its lack of clinical specificity,so its diagnosis should be dependent on biopsies.Laboratory data that are relatively specific are increased eosinophilic granulocyte in peripheral blood and serum IgE,and some patients were accompanied by kidney damage.Treatments of KD include excision,glucocorticoids treatment and radiotherapy.

关 键 词：木村病 嗜酸粒细胞增多 嗜酸性肉芽肿 体征和症状 活组织检查 诊断 治疗 

分 类 号：R557.5[医药卫生—血液循环系统疾病]