儿童肾病综合征合并嗜酸性粒细胞增多的临床分析

目的 探讨儿童肾病综合征（NS）合并嗜酸性粒细胞增多的临床特点。方法 回顾性分析合并嗜酸性粒细胞增多的18例次NS患儿（15例,其中3例于第2次复发时也有嗜酸性粒细胞增多）的临床表现、实验室检查和治疗转归。结果 嗜酸性粒细胞轻度增多16例次（89%）、中度增多1例次（6%）、重度增多1例次（6%）。12例次（67%）的嗜酸性粒细胞增多发生在冬春季。9例次（50%）合并感染性疾病：4例肺炎（其中2例为支原体肺炎）、3例EB病毒感染、1例疑似蛲虫感染、1例链球菌感染;5例次（28%）合并过敏性疾病,其中2例表现为荨麻疹,2例表现为过敏性鼻炎,1例表现为湿疹。嗜酸性粒细胞计数与尿蛋白定量、血白蛋白、胆固醇水平均无明显相关性（P > 0.05）。8例次初发NS患儿,激素治疗后尿蛋白4周内转阴;10例次复发NS患儿,9例次患儿调整激素治疗后尿蛋白亦转阴。1例次（嗜酸性粒细胞中度增多）合并过敏性鼻炎的NS患儿予以抗过敏等对症治疗后症状缓解、尿蛋白转阴,未恢复激素治疗,嗜酸性粒细胞计数降至轻度增多;余17例次患儿嗜酸性粒细胞均恢复正常。结论 NS合并嗜酸性粒细胞增多多发生于冬春季节,常合并感染或过敏性疾病,嗜酸性粒细胞计数与尿蛋白定量、血白蛋白、胆固醇水平均无明显相关性。     

嗜酸粒细胞增多症5例临床分析

嗜酸粒细胞增多症(eosinophilia)临床多见.为引起儿科医师的重视,避免误诊及漏诊,现将我院近3年来收治的5例引起嗜酸性粒细胞增多的少见原因报告如下.     

40例儿童嗜酸性粒细胞增多症临床分析及远期随访

嗜酸性粒细胞增多症(eosinophils)是一种临床综合征,病因及临床表现多样,易漏/误诊.现将我院1996年1月至2008年1月收治的40例嗜酸性粒细胞增多症患儿的临床特点和随诊结果报告如下.     

新生儿嗜酸性粒细胞增多

目的　探讨新生儿嗜酸性粒细胞增多的原因 ,评价新生儿嗜酸性粒细胞增多的临床特征。方法　对 2 4例新生儿嗜酸性粒细胞增多患儿 ,监测血嗜酸性粒细胞计数 ,检测Ig系列 ,详细记录患儿入院后情况及患儿家属情况 ,并对所有患儿进行随访。结果　在同期住院的 10 5 2例新生儿中 ,2 4例 (2 .3% )患儿存在嗜酸性粒细胞增多。嗜酸性粒细胞轻度增高占 2 9.2 % ,中度增高 5 4 .2 % ,重度增高 16 .7%。嗜酸性粒细胞增多的时间为入院后 0～ 2 0d不等 ,其中 2 5 .0 %患儿入院当时即发现有嗜酸性粒细胞增多 ,2 9.2 %患儿为入院后 1d发现有嗜酸性粒细胞增多 ,2例化脓性脑膜炎患儿在恢复期出现嗜酸性粒细胞增多。在Ig系列中 ,IgA增高 6例 (2 5 .0 % ) ,IgE增高 2例 (8.3% )。嗜酸性粒细胞增多患儿的恢复时间为 2～ 2 1d。患儿出院后 ,对所有患儿进行随访 ,其中 3例(12 .5 % )患儿有湿疹存在。截止至随访日期 ,尚未发现有过敏及哮喘发作。结论　嗜酸性粒细胞增多在新生儿期并不少见 ,常见的原因与新生儿感染有关。     

儿童嗜酸性粒细胞增多症伴肾病综合征1例

患儿,男,7岁。因反复水肿伴腹痛、呕吐8 d,水肿加重2 d入院。患儿8 d前无明显诱因出现双眼睑水肿,伴咽痛、腹痛,非喷射性呕吐,近2 d水肿加重,逐渐蔓延至四肢及腹部,无发热、寒战,无尿频、尿急、尿痛,精神、食纳可,小便为浓茶样,偶为洗肉水样,大便正常。既往有腹股沟斜疝手术史,对鸡     

淋巴细胞变异型嗜酸性粒细胞增多症基础与临床

嗜酸性粒细胞增多性疾病是一组异质性疾病,表现为血液以及组织中嗜酸性粒细胞持续性增多,并因嗜酸性粒细胞增殖所产生的炎症物质而造成微环境的改变和慢性不可逆的器官损害。世界卫生组织根据有无器官受累,将嗜酸性粒细胞增多性疾病分为嗜酸性粒细胞增多症(HE)和嗜酸性粒细胞增多综合征(HES)。除家族性HE外,又分为继发性(反应性)、原发性(克隆性)和特发性HE。而淋巴细胞变异型HE是继发性HE的一种特殊类型。随着对淋巴细胞变异型HE发生的分子机制的研究,其诊断逐渐明确,并且一些靶向治疗药物如抗IL-5单克隆抗体Mepolizumab、抗CD 52单克隆抗体Alemtuzumab也相继出现。文章综述淋巴细胞变异型HE的基础与临床现况。     

单倍体造血干细胞移植治疗特发性嗜酸性粒细胞增多症1例

1 病例资料 患儿女,6岁11月,以"发现嗜酸性粒细胞增多4年余"于2019年5月15日入院.4年前发现腹部包块,检查发现脾大、白细胞及嗜酸性粒细胞异常增多,给予泼尼松及别嘌呤醇治疗,2个月后诊断"特发性嗜酸性粒细胞增多症",继续口服泼尼松治疗半年余疗效不佳,又先后加用羟基脲、长春新碱、环孢素、IFN-α治疗,嗜酸性粒...     

嗜酸性粒细胞增多综合征2例并文献复习

目的了解儿童特发性嗜酸性粒细胞（EOS）增多综合征（HES）的诊断及治疗特点。方法通过复习相关文献并结合本院2005年收治的2例HES患儿临床资料及实验室检查,了解本病的临床表现、诊断、鉴别诊断、治疗及儿童和成人患者的异同。结果2例患儿虽均表现为HES,但1例转归为恶性过程,最终考虑为EOS白血病;而另1例经治疗病情稳定。结论儿童HES表现有其自身特点,但仍以EOS增多引起脏器损伤为主要表现,而FIP1L1-PDGFRA融合基因检测及T淋巴细胞功能异常,对本病的诊断及治疗具有重要意义。     

儿童肺吸虫病合并继发血小板增多症与嗜酸性细胞增多症(附1例报道)

患儿，女，5岁，因咳嗽两月，发现血小板增多6天入院。患儿两月前无明显诱因出现咳嗽，呈阵发性，无痰，无呼吸困难，抗炎治疗无好转。近1月开始出现间断发热，咳嗽、咳痰加剧，咳后有鸡呜样回声，6天前入当地医院住院治疗，血常规WBC25．7×10^9／L、Hb92g／L、Plt 1171×10^9／L，胸片示“支气管肺炎”，腹部B超发现肠淋巴结肿大，诊断为“支气管肺炎、肠系膜淋巴结肿大、血小板增多待查”。[第一段]     

Esophageal eosinophilia in children with dysphagia

OBJECTIVES: Children occasionally have dysphagia in the absence of an apparent primary cause. Esophageal eosinophilia is sometimes seen in these patients at the time of upper endoscopy but its significance is not clear. Although eosinophilia is regarded by some as a histologic hallmark of childhood reflux esophagitis, it may in fact signal a primary eosinophilic esophagitis in children with dysphagia. Our aim was to evaluate esophagitis, acid reflux determined by pH probe, and esophageal eosinophilia in children with the primary complaint of dysphagia. METHODS: A retrospective study was performed in 42 children, admitted for investigation of dysphagia, in whom no primary cause could be found. Twenty-one children (mean age +/- SD, 10.1 +/- 4.0 years) had esophageal eosinophilia and 21 children (8.3 +/- 4.7 years) did not. Clinical, endoscopic, manometric and esophageal pH parameters in these two groups were compared. RESULTS: Patients with esophageal eosinophilia were more often male (p<0.01) with a history of allergy (p<0.001) and food bolus obstruction (p<0.05) requiring endoscopic removal. Their esophageal mucosa appeared wrinkled and thickened at endoscopy with basal cell proliferation, and large numbers of eosinophils in esophageal mucosal biopsies. Continuous esophageal pH records and motility studies, when obtained, were similar in both groups and were within normal values. CONCLUSION: Children with dysphagia who have esophageal eosinophilia are unlikely to have pathologic gastroesophageal reflux.     

Transient hyperphosphatasemia of infancy. Fifteen new cases

Alkaline phosphatase was assayed as part of the routine examinations performed in all children hospitalized for the first time in our ward. Fifteen children had transient hyperphosphatasemia of infancy (THI). Their clinical features suggested the presence of an infectious agent.     

Pulmonary infiltrates with eosinophilia syndromes in children

Pulmonary infiltrates with eosinophilia (PIE) are a group of heterogeneous disorders having the common findings of lung disease and eosinophilia in the peripheral blood, bronchoalveolar lavage fluid, or pulmonary interstitium. Eleven cases of PIE syndromes were identified through a retrospective and prospective chart review: drug-induced (2), acute eosinophilic pneumonia (3), infant pulmonary eosinophilia (2), parasite-induced (2), Churg-Strauss syndrome (1), and atypical chronic PIE (1). Patient demographics, clinical presentation, and disease severity varied considerably among groups. Therapeutic interventions included bronchodilators (10), oxygen (7), corticosteroids (9), and mechanical ventilation (3). A single patient with acute eosinophilic pneumonia died. Our experience suggests that PIE syndromes are rare in childhood and that clinical presentation can vary widely. Because of the potential for significant morbidity and mortality, aggressive diagnostic evaluations are warranted, particularly in children with respiratory failure of unknown etiology.     

High prevalence of eosinophilia in growth hormone-deficient children

BACKGROUND: To determine the clinical significance of eosinophilia in growth-hormone (GH)-deficient children, a clinical study consisting of 72 children and adolescents (mean age 9 years and 6 months at diagnosis) with GH deficiency (GHD) was undertaken. Patients were treated with GH, along with supplementation for the combined deficiency in patients with multiple hormone deficiency. METHODS: A complete blood count and hemogram with microscopic examination of a peripheral blood smear was performed. RESULTS: Before treatment, differential eosinophil counts exceeded 5% in 30 subjects (41.7%) and absolute eosinophil counts were >350 /microL in 27 subjects (37.5%). Growth hormone therapy did not significantly affect eosinophil counts. There was an inverse relationship between absolute eosinophil count and peak GH value in response to the L-dopa stimulation test (n=65; Rs=-0.252; P=0.044). CONCLUSIONS: For the diagnosis of GHD, one should take into account that GH response to L-dopa stimulation can be selectively blunted in patients with eosinophilia.     

尸检证实的新生儿胸腺意外性退化15例分析

目的　新生儿胸腺退化与疾病发生发展密切相关 ,国内研究较少。该研究探讨了新生儿胸腺意外性退化的可能因素 ,为临床诊治提供帮助。方法　对该院 2 0 0 0年 1月至 2 0 0 3年 10月尸检证实为胸腺意外性退化的 15例新生儿资料进行回顾性分析。结果　 15例新生儿中胸腺重度退化 10例 ,中度退化 2例 ,轻度退化 3例。胸腺重量 3.82± 1.86 g,最小重量仅 1.4 6 g,平均死亡时间为生后 7.6d。 15例中早产儿 11例 ,呼吸窘迫综合征 9例 ,重度窒息 7例 ,肺出血 8例 ,先天性心脏病 3例 ,化脓性肺炎 5例 ,深部真菌感染 4例。其中 13例使用过地塞米松。结论　新生儿胸腺意外性退化并不少见 ,缺氧、重症感染、使用过地塞米松等因素可能是造成胸腺意外性退化的主要原因。     

Albendazole therapy for coagulation abnormality in children with eosinophilia

Hemorrhage may be associated with eosinophilia. Here, 2 pediatric cases of coagulation abnormality were reported. The 2 children presented ecchymoses and petechiae in the skin. Laboratory investigations revealed hypereosinophilia in the peripheral blood. Moreover, the activity of coagulation factor IX significantly decreased. The serum immunoglobulin G (IgG) antibody to cysticercus was positive in patient 1, and IgG antibodies to cysticercus and plerocercoid were positive in patient 2. These 2 patients received 2 courses of albendazole therapy, at 15 mg/kg/day in divided doses for 10 days for each course. They responded well to the therapy. This report indicates that patients with hypereosinophilia and bleeding abnormalities should undergo evaluation of coagulation pathways, including measurements of coagulation factors.