Abstract
Objective To investigate the clinical characteristics and treatment responses of children with eosinophilic gastroenterirtis(EoG). Methods 36 children who were diagnosed with EoG by endoscopy in Department of Digestive Pediatric in the First People's Hospital of Zhengzhou City from September 2006 to March 2015,were retrospectively analyzed. The clinical manifestation,laboratory test results,serological indicators,stool test,stool parasite eggs detection,abdominal imaging studies ( abdomen B ultrasonography and abdominal CT scan),gastrointestinal endoscopic findings( eosinophil count for biopsy specimen),detection of helicobacter pylori(HP),the microscopic performance(gastrointestinal endoscopic and microscope) and medication were recorded. Results The main clinical manifestation was abdominal pain(75. 0% ),the main comorbidity was eczema(63. 9% ),the main complication was anemia(52. 8% ). All cases received blood routine examination,increased peripheral blood eosinophil count was found among 28 cases(77. 8% ),among these 28 cases,eosinophil count of 11 cases increased slightly,eosinophil count of 7 cases increased moderately,eosinophil count of 10 cases increased severely. Increased serum IgE level was found among 30 cases(83. 3% ),increased allergen IgE level was foud among 34 cases(94. 4% ),fecal occult blood test result was positive among 4 cases(11. 1% ),parasitic ovum was not found among all cases. All cases received abdominal imageological examination. According to abdomen B ultrasonography results,24 cases(66. 7% )had thickening of gastric wall and intestines wall,1 case(2. 8% )had seroperitoneum complicated with pleural effusion,no positive finding was found among 11 cases(30. 5% ). According to abdominal CT scan results,27 cases(75. 0% )had thickening of gastric wall and intestines wall,among whom 7 cases had thickening of terminal ileum wall and cecum wall,and abdominal lymph node enlargement was found. All cases received gastrointestinal endoscopy,according to eosinophil count result for multi - site biopsy, increased eosinophil count was found in stomach and duodenal hemorrhage among 58. 3% of cases,increased eosinophil count was found in esophagus among 5. 6% of cases. 7 cases(19. 4% )had positive HP and received anti - HP treatment. All cases received gastrointestinal endoscopy,nonspecific changes such as gastrointestinal mucosa erythema,granular changes of mucous membrane,erosion,bleeding and anabrosis were found under gastroscope,17 cases(47. 2% )had granular changes of mucous membrane,among whom 7 cases had anabrosis, 1 case had granular changes of mucous membrane with reflux esophagitis. According to enteroscopy findings,granular hyperplasia and erosion of mucous membrane was found in colon and ileocecal junction,there were 1 - 7 biopsy sites. 3 cases(8. 3% )aged between 7 weeks and 10 months were treated with diet modification,3 cases(8. 3% )were treated with oral steroids,13 cases(36. 1% )were treated with hormone by intravenous drip,2 cases(5. 6% )were treated with the oral montelukast plus steroids,15 cases(41. 7% )were treated with the oral montelukast plus hormone by intravenous drip. After diet modification and hormone treatment,54. 5% cases(18 / 33)were cured without recurrence. Conclusion EoG has diverse clinical and endoscopic manifestitons. The key point of the diagnosis is that the eosinophil count in peripheral blood and pathological biopsies increased significantly. Steroid is the main treatment for active diseases,montelukast is also effective as a maintenance therapy in this study.关键词
嗜酸粒细胞/胃肠炎/儿童/临床特征Key words
Eosinophilic granulocyte/Gastroenteritis/Child/Clinical characters分类
医药卫生
