播散性嗜酸细胞性胶原病

末梢血液中嗜酸细胞增多,见于寄生虫病和变态反应性疾患,这是人们所熟知的。但是,一群呈现嗜酸细胞增多的稀有疾患,虽经多方面研究,其病因仍未阐明。1956年,Engfeldt等叙述了一种嗜酸细胞显著增多,全身组织有嗜酸细胞浸润,表现为多系统病变的疾患,并提议称为播散性嗜酸细胞性胶原病(DECD)。随后,人们把显示嗜酸性细胞增多,伴有与此病相似全身症状的其他疾患,相继报告为嗜酸细胞性白血病、播散性内脏损害伴高度嗜酸细胞增多、肺浸润型心包炎和嗜酸细胞     

嗜酸细胞性胃肠炎研究进展

嗜酸细胞性胃肠炎(eosinophilic gastroenteritis,EG)是一种少见的胃肠道疾病,以胃肠道某些部位弥漫性或局限性嗜酸性粒细胞(Eos)浸润为特征。胃和小肠为最常受累部位,可发生于任何年龄,其好发年龄为30～50岁,儿童时期较罕见,男性发病率高于女性。由于许多EG患者被误     

儿童嗜酸细胞性胃肠炎研究进展

儿童嗜酸细胞性胃肠炎(EG)是一种少见的胃肠道疾病.目前发病机制不甚明确,可能是对外源性或内源性变应原的全身或局部变态反应所致.嗜酸性粒细胞浸润的范围和深度导致该病临床表现的多样化.诊断的金标准取决于内镜多点活检、腹水找嗜酸性粒细胞及腹腔镜检查等.治疗主要有激素治疗及其他药物治疗.近年来对该病的临床诊治有许多新的观点,现就儿童EG临床研究进展作一综述.     

嗜酸细胞性脑膜炎1例

嗜酸细胞性脑膜炎,自1945年台湾的野村等报告以来,泰国、台湾、夏威夷等东南亚及太平洋诸岛,都有发病。本病是感染了鼠的肺寄生—广东住血线虫的幼虫所引起的。人是由蜗牛、蚰蜒等中间宿主,经皮肤     

嗜酸细胞性胃肠炎11例

目的分析小儿嗜酸细胞性胃肠炎(EG)的临床特点、诊断要点、治疗预后和误诊原因。方法本院2006-2008年收治EG患儿11例,对其病史、临床特点、实验室检查、内镜表现和治疗、随访情况进行回顾性分析,应用SPSS10.0软件进行统计学分析。结果1.EG患儿的临床表现多样,包括腹痛(5例)、腹泻(7例)、便血(5例)、低热(2例)等。2.EG患儿中54.55%的过敏体质与EG发病密切相关。3.所有患儿中,18.18%外周血中嗜酸性粒细胞(EOS)计数增高明显,可随症状缓解而下降。4.患儿内镜表现均无明显特异性,可见到黏膜片状糜烂、浅溃疡、散在充血斑或出血点,以胃窦、十二指肠、回肠末端、回盲部最明显,活检可见大量EOS浸润。5.影像学检查无特异性,10例(90.91%)黏膜型CT或消化道钡餐检查无特殊发现,1例(9.09%)肌型肠壁肌层受累时见不全梗阻。6.激素为治疗EG的一线药物,可迅速缓解症状,并使EOS恢复正常。7.本病是一种自限性变应性疾病,虽可反复发作,但长期随访未见恶变,多数预后良好。结论EG的临床表现和内镜表现均无特异性,胃肠黏膜组织中EOS增多是诊断的关键。本病极易造成误诊,明确诊断需依靠活组织病理...     

非嗜酸细胞性哮喘研究进展

支气管哮喘（哮喘）是由多种细胞[嗜酸性粒细胞（EOS）、肥大细胞、T淋巴细胞、中性粒细胞及呼吸道上皮细胞等]和细胞组分共同参与的呼吸道慢性炎性疾病。以往研究多认为哮喘呼吸道局部改变是以EOS为主的炎性反应,近年来一些诱导痰检查发现部分哮喘呼吸道局部炎性反应并非以EOS为主,而是以其他细胞如中性粒细胞、淋巴细胞、肥大细胞等为主,因此有研究将哮喘分为嗜酸细胞性哮喘（EA）和非嗜酸细胞性哮喘（NEA）两个亚型,前者呼吸道局部以EOS炎性反应为主,后者呼吸道局部则以非EOS炎性反应为主。本文就NEA发病机制及可能病因等进行综述。     

嗜酸细胞性膀胱炎一例

患儿男,8岁,因尿频半年、B超发现膀胱壁包块1 d入院.既往无过敏史.入院查体:一般情况良好,全身皮肤浅表淋巴结未触及肿大,腹部平软,未触及明显增大的膀胱,膀胱区无明显压痛.检查尿白细胞(离心尿)0～4个/高倍镜视野(HPF),尿蛋白(+),血常规WBC 12.85×109/L,嗜酸性粒细胞计数4.19×109/L,嗜酸性粒细胞百分率32.61%;B超显示:膀胱前壁及右侧壁探及环形不规则异常光团,呈基本均匀稍低回声.膀胱逆行造影检查见膀胱呈三角形偏小的形态充盈,密度均匀,边缘光整.清洁中段尿培养(4 d)未见细菌生长.     

嗜酸细胞性肺炎

嗜酸细胞性肺炎 (ｅｏｓｉｎｏｐｈｉｌｉｃｐｎｅｕｍｏｎｉａ)属于一种变态反应性综合征 ,又称肺部浸润伴嗜酸细胞增多综合征 (ｐｕｌｍｏｎａｒｙｉｎｆｉｌｔｒａｔｉｏｎｗｉｔｈｅｏｓｉｎｏｐｈｉｌｉａｓｙｎｄｒｏｍｅ) ,以肺部浸润同时伴周围血中嗜酸性粒细胞增高为特征[1] 。其诊断要点[2 ] 是 :①持续性咳嗽喘息或胸部听诊有 口罗 音或哮鸣音 ,②Ｘ线胸片有肺部浸润并经常迁移 ,③外周血或肺活检标本可见大量嗜酸细胞。临床上常见以下四种类型。1　单纯性肺嗜酸细胞增多症 (Ｌ ｆｆｌｅｒ综合征 ) [3]本病与寄生虫蚴虫移行有关 …     

儿童嗜酸细胞性胃肠炎1例

患儿男,11岁,因腹泻11 d,腹胀7 d入院.11 d 前食用鱼虾后出现黏液水样便,10余次/日,伴恶心、间断性腹痛、呕吐.按"急性肠炎"予抗感染治疗,疗效差.     

儿童嗜酸细胞性膀胱炎诊治分析

目的 探讨儿童嗜酸细胞性膀胱炎的临床表现、诊断和治疗方法.方法 回顾性分析2001年12月至2009年2月本院收治的4例嗜酸细胞性膀胱炎患儿的临床资料.结果 患儿主要表现为明显的下尿路症状,通过膀胱镜检查和膀胱活检确诊,采用抗组胺药物和激素治疗效果满意,预后良好.结论 嗜酸细胞性膀胱炎是以嗜酸性粒细胞膀胱浸润为主要特征的临床少见疾病,明确诊断后治疗效果明显,预后良好.     

Chronic eosinophilic pneumonia in a 13-year-old child

We report a case of a 13-year-old girl with an asymptomatic isoniazid-resistant tuberculosis contact. Six months after the contact had been made, chest radiography showed left upper lobe infiltrates without hilar lymphadenopathy, which led to the start of an antituberculous treatment. Tuberculin skin test remained negative and blood tests showed hypereosinophilia. One month after the onset of the treatment, she presented with asthenia, weight loss, and cough. She was admitted to our unit with a diagnosis of drug-resistant tuberculosis. Blood tests showed the persistence of hypereosinophilia. Chest radiograph and high-resolution lung computed tomography (CT) scan showed alveolar peripheral condensations on both upper lobes without significant hilar lymphadenopathy. Bronchoalveolar lavage (BAL) showed a normal total cell count with 44% of eosinophils. Microbiological analyses were all negative. Chronic eosinophilic pneumonia (CEP) was confirmed after the elimination of other different eosinophilic lung diseases. The patient was highly responsive to high doses of oral corticosteroids. Dyspnoea and cough disappeared within one week and chest CT scan showed regression of the lung infiltrates within one month. No relapse occurred during the following nine months.     

胃食管反流引起的慢性咳嗽

胃食管反流 (GER)是指胃内容物频繁地逆流到食管内 ,从而引起一系列症状的临床综合征。病理性反流伴有症状时称胃食管反流病 (GERD)。近年来GER和慢性咳嗽的因果关系越来越引起人们的重视。伴有GERD的慢性咳嗽经治疗后症状明显减轻 ,但与GER有关的慢性咳嗽患儿没有成人所具有的典型的反酸、烧心等反流症状 ,因而易造成临床医师的误诊及漏诊从而延误诊治。现结合本院 10年来对慢性咳嗽患儿进行动态 2 4h食管pH值监测的研究 ,就与GER有关的慢性咳嗽的发生率、发病机制、诊断及治疗讨论如下。1　发生率近年来GER与慢性咳嗽的关系已受…     

Chronic cough in children

Chronic cough in children is a frequent complaint seen by the primary health care provider. Although many of these coughs spontaneously resolve, some are caused by a more serious process and require further attention. Selecting those patients who will benefit from a more extensive evaluation can be a difficult challenge. An overview is provided that emphasizes a systematic approach to the diagnosis and management of chronic cough.     

Chronic and recurrent cough

1.Bronchitis In the majority of patients with recurrent cough the cause is asthma or bronchitis. The main characteristics are episodic cough, usually associated with bouts of fever and malaise and in asthma with wheezing. It is unusual for sputum to be produced. Clinically the signs may be inspiratory and expiratory rhonchi and coarse crepitations but often the chest will be clear. Radiologically the hilar regions are prominent and bronchovascular markings increased, and there is no evidence of parenchymatous involvement. 2. Suppurating lung disease In this group of patients the cough is persistent and the patient is never free of cough. Purulent sputum can usually be produced if the child is postured and taught to cough and expectorate. Often there will be few signs in the chest, usually no more than a few crepitations. Radiologically there will almost invariably be parenchymatous involvement, either lobar, segmental or lobular collapse or pneumonic changes 3. Focal lesions A pathological lesion in the lumen, or wall, or which presses on or infiltrates the bronchial tree may cause a persistent dry cough by irritation of the sensitive receptors. The cough is usually unproductive and sounds dry. Secondary infection consequent on obstruction of the bronchial lumen is not common. Stridor or wheezing may be associated with the cough if the larynx, trachea or larger airways are significantly narrowed. Most of the lesions are relatively uncommon and their nature will only be determined by special methods using radiology and endoscopy 4. Nervous or psychogenic cough The two principal features are overt or covert parental anxiety about the child's cough and lack of any evidence of underlying respiratory disease     

Hypertrophic osteoarthropathy caused by lipoid pneumonia

A case of hypertrophic osteoarthropathy in a 5-year-old Saudi boy is presented. The child developed painful joints, was found to have clubbing of fingers and radiologically hypertrophic osteoarthropathy was demonstrated. The underlying cause of the condition was ingestion of animal fat in infancy, with a history of ghee oil aspiration which caused a chronic lung inflammation, lipoid pneumonia, proven by lung biopsy.