腹水貯留と広範囲な腸管壁の肥厚を伴う好酸球性胃腸炎の1例

A 60-year-old woman was admitted to our hospital with abdominal pain and diarrhea. Examination revealed eosinophilia (white blood count, 24,900/ml; eosinophils, 79.9%) and an elevated immunoglobulin E level. Abdominal computed tomography showed fluid collection and diffuse intestinal wall thickening, and biopsy specimens from the stomach, duodenum and colon showed eosinophil infiltration. We diagnosed the patient with eosinophilic gastroenteritis, and started treatment with steroid hormones (predonisolone, 40 mg/day perorally). The patient's symptoms and eosinophilia improved dramatically and she was discharged. Eosinophilic gastroenteritis is an inflammatory disease characterized by eosinophil infiltration into the gastrointestinal tract. It usually involves the stomach and small intestine, but may also involve the entire whole gastrointestinal tract. Although ascites sometimes complicates this disease, massive ascites, as in our patient, is rare. Here we report a case of eosinophilic gastroenteritis with massive ascites and diffuse intestinal wall thickening. Steroid hormones are an effective treatment for this disease, and early diagnosis and the administration of steroid hormones are essential.

症例報告