1例嗜酸性粒细胞性胃肠炎误诊为腹腔结核的病例报道  

Case Report of One Patient with Eosinophilic Gastroenteritis Misdiagnosed as Abdominal Tuberculosis

作　　者：彭羽静 胡清亮 严晓峰[1] PENG Yu-jing;HU Qing-liang;YAN Xiao-feng(Chongqing Public Health Medical Center,Chongqing 400036,China)

机构地区：[1]重庆市公共卫生医疗救治中心,重庆400036

出　　处：《抗感染药学》2023年第10期1099-1102,共4页Anti-infection Pharmacy

摘　　要：目的:分析1例误诊为腹腔结核的嗜酸性粒细胞性胃肠炎病例的临床资料,了解嗜酸性粒细胞胃肠炎的临床特征及确诊方法,以减少误诊。方法:回顾性分析1例嗜酸性粒细胞性胃肠炎患者误诊为腹腔结核的诊疗过程,结合相关文献,总结该病的临床特点、诊疗方法、治疗措施与临床疗效。结果:该患者的主要临床表现为腹胀,有持续性腹腔积液,影像学改变提示肠道病变,内镜检查提示回盲部病变,疾病初期考虑为腹腔结核,予以诊断性抗结核治疗未取得持续性疗效,且临床症状逐渐加重,再次行内镜检查,病理活检提示嗜酸性粒细胞浸润,诊断为嗜酸性粒细胞性胃肠炎,给予糖皮质激素治疗后,临床症状很快缓解。结论:嗜酸性粒细胞性胃肠炎的临床表现多样,早期诊断困难,在抗结核治疗效果欠佳,尤其是血常规提示嗜酸性粒细胞增多时要考虑该病可能,病理活检可以明确其诊断,糖皮质激素治疗该病较为有效。Objective:To analyze the clinical data of one patient with eosinophilic gastroenteritis misdiagnosed as abdominal tuberculosis,and understand the clinical characteristics and diagnosis methods of eosinophilic gastroenteritis,so as to reduce the misdiagnosis.Methods:Aretrospective analysis was performed on the diagnosis and treatment process of one patient with eosinophilic gastroenteritis misdiagnosed as abdominal tuberculosis,and the clinical characteristics,diagnosis and treatment methods,treatment measures and clinical efficacy of the disease were summarized combined with relevant literature.Results:The patient had main clinical manifestations of abdominal distension and persistent peritoneal effusion.The imaging changes revealed intestinal lesions and the endoscopy showed ileocecal lesions.In the early stage of the disease,it was considered as abdominal tuberculosis,and the diagnostic anti-tuberculosis treatment was given,but no sustained efficacy was achieved;the patient's clinical symptoms gradually worsened,and the endoscopy was performed again.The pathological biopsy showed eosinophil infiltration,and the patient was diagnosed as eosinophilic gastroenteritis.After glucocorticoid treatment,the patient's clinical symptoms were relieved quickly.Conclusion:The clinical manifestations of eosinophilic gastroenteritis are diverse and early diagnosis is difficult.When the anti-tuberculosis treatment is not effective,especially when the blood routine test shows increased count of eosinophils,it is possibly eosinophilic gastroenteritis.The pathological biopsy can confirm the diagnosis and glucocorticoids can be used to treat this disease effectively.

关 键 词：嗜酸性粒细胞性胃肠炎 腹腔结核 误诊 

分 类 号：R52[医药卫生—内科学] R447[医药卫生—临床医学]