以皮肤损害为突出表现的嗜酸性粒细胞增多综合征1例
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摘要
患者女,35岁,全身皮肤红斑、丘疹、肥厚伴瘙痒7年,加重6个月。外周血、骨髓涂片及活检、流式细胞术检测均提示嗜酸性粒细胞明显增多;皮损组织病理改变符合嗜酸性粒细胞增多综合征;淋巴结活检:淋巴结不典型增生,伴较多浆细胞及少量嗜酸性粒细胞浸润。IgE 7 100 IU/mL; HBsAg(+)、抗HBsAg(-)、HBeAg(+)、抗HBeAg(-)、抗HBcAg(+);乙肝病毒DNA定量:2. 04E+002。诊断:嗜酸性粒细胞增多综合征、慢性乙型肝炎。采用糖皮质激素联合抗乙肝病毒药物治疗,疗效显著。
A 35-year-old female presented with generalized erythema,rash,and thickened rough skin with severe itching for 7 years,which was aggravated for 6 months.The eosinophils in peripheral blood,the bone marrow smear,biopsy,and FCM showed marked elevation.The histopathological examination of the skin specimen was consistent with the diagnosis of eosinophilia syndrome.Lymph node biopsy revealed atypical lymphoid hyperpiasia with numerous plasma cells and a small proportion of eosinophils infiltation.Elevated serum IgE levels(7 100 IU/mL),serum HBsAg(+),anti-HBsAg(-),HBeAg(+),anti-HBeAg(-),anti-HBcAg(+),and Serum HBV-DNA level of 2.04E+002 were noted.She was diagnosed as hypereosinophilic syndrome and chronic hepatitis B.After glucocorticoid combined with anti HBV treatment,the absolute eosinophil count returned to normal.
A 35-year-old female presented with generalized erythema,rash,and thickened rough skin with severe itching for 7 years,which was aggravated for 6 months.The eosinophils in peripheral blood,the bone marrow smear,biopsy,and FCM showed marked elevation.The histopathological examination of the skin specimen was consistent with the diagnosis of eosinophilia syndrome.Lymph node biopsy revealed atypical lymphoid hyperpiasia with numerous plasma cells and a small proportion of eosinophils infiltation.Elevated serum IgE levels(7 100 IU/mL),serum HBsAg(+),anti-HBsAg(-),HBeAg(+),anti-HBeAg(-),anti-HBcAg(+),and Serum HBV-DNA level of 2.04E+002 were noted.She was diagnosed as hypereosinophilic syndrome and chronic hepatitis B.After glucocorticoid combined with anti HBV treatment,the absolute eosinophil count returned to normal.
引文
[1]Gotlib J.World Health Organization-defined eosinophilic disorders:2015 update on diagnosis,risk stratification and management[J].Am J Hematol,2015,90(11):1077-1089.
[2]Curtis C,Ogbogu P.Hypereosinophilic syndrome[J].Clinic Rev Allerg Immunol,2016,50(2):240-251.
[3]Valent P,Klion AD,Homy HP,et al.Contemporary consensus proposal on criteria and classification of eosinophilic disorders and related syndromes[J].J Allergy Clin Immunol,2012,130(3):607-612.
[4]张萨丽,徐传辉,穆荣.2012年版嗜酸性粒细胞增多症及相关综合征分类标准的共识[J].中华风湿病学杂志,2013,17(1):58-59.
[5]周臣敏.免疫球蛋白检测在乙型肝炎患者病情及预后判断的临床意义[J].国际检验医学杂志,2013,34(3):376-377.
[6]孙青.嗜酸性粒细胞增多综合征的诊断与治疗[J].皮肤病与性病,2013,35(6):325-327.
[7]江阳,朱小娟,刘娟娟,等.嗜酸性粒细胞增多综合征1例[J].中国皮肤性病学杂志,2012,46(1):64-65.
[2]Curtis C,Ogbogu P.Hypereosinophilic syndrome[J].Clinic Rev Allerg Immunol,2016,50(2):240-251.
[3]Valent P,Klion AD,Homy HP,et al.Contemporary consensus proposal on criteria and classification of eosinophilic disorders and related syndromes[J].J Allergy Clin Immunol,2012,130(3):607-612.
[4]张萨丽,徐传辉,穆荣.2012年版嗜酸性粒细胞增多症及相关综合征分类标准的共识[J].中华风湿病学杂志,2013,17(1):58-59.
[5]周臣敏.免疫球蛋白检测在乙型肝炎患者病情及预后判断的临床意义[J].国际检验医学杂志,2013,34(3):376-377.
[6]孙青.嗜酸性粒细胞增多综合征的诊断与治疗[J].皮肤病与性病,2013,35(6):325-327.
[7]江阳,朱小娟,刘娟娟,等.嗜酸性粒细胞增多综合征1例[J].中国皮肤性病学杂志,2012,46(1):64-65.