好酸球性胃腸炎の1例

Eosinophilic Gastroenteritis, Report of a Case

要旨　好酸球性胃腸炎の1例を経験した．患者は38歳，男性．上腹部痛，嘔吐を主訴として1998年10月5日入院．末梢血白血球数，好酸球の著明な増加を認めた．腹部超音波検査および腹部CT検査で腹水貯溜と左上腹部の小腸の壁肥厚を認めた．腹水穿刺所見では好酸球の増多を認めた．小腸X線検査では十二指腸から空腸にかけてKerckring皺襞の著明な腫大を認めた．上部消化管内視鏡検査では十二指腸にKerckring皺襞の著明な腫大を認めた．十二指腸生検組織所見では粘膜の浮腫と間質に多数の好酸球浸潤を認めた．以上から好酸球性胃腸炎と診断しステロイドが投与され，2週間で臨床症状，腹部超音波所見，腹部CT所見，上部消化管内視鏡所見および病理組織学的所見は著明に改善した．

　A case of eosinophilic gastroenteritis was encountered. The case in volved a 38-year-old male who was admitted on 5th Oct., 1998, with upper abdominal pain and vomiting as his chief comptains. Laboratory data on admission showed leukocytosis with remarkable eosinophilia. Ultrasonography and computed tomography demonstrated ascites and diffuse wall thickening of the jejunum. Aspirared ascites showed increase in eosinocytes. Radiographic examination of the small intestine showed thickening of Kerckring's folds in the duodenum and jejunum. Gastrointestinal endoscopy revealed marked thickening of Kerckring's folds in the duodenum. A biopsy specimen from the lesion of the duodenum revealed edema and diffuse infiltration of eosinophils in the mucosal layer. The case was diagnosed as eosinophilic gastroenteritis and the patient's clinical symptoms, ultrasonographic and computed tomographic findings, endoscopic findings and histological findings improved significantly with corticosteroid therapy over a peried of weeks.