Abstract：
A 76-year-old woman with persistent diarrhea was referred to our hospital. She had purpura, peripheral eosinophilia (18,177/μL), and an elevated serum IgG4 level (819 mg/dL). Abdominal computed tomography revealed massive ascites and bowel edema. A skin biopsy of the purpura revealed leukocytoclastic vasculitis with prominent eosinophilic infiltration. Biopsies of the gastrointestinal mucosa revealed dense eosinophilic infiltration, indicating eosinophilic gastroenteritis (EG) associated with the hypereosinophilic syndrome. The number of IgG4-positive cells increased in the duodenal mucosa; however, the diagnostic criteria for IgG4-related disease (IgG4-RD) were not met. Whether or not EG with ascites is a manifestation of IgG4-RD warrants further investigation.
摘要：
一名患有持续性腹泻的76岁妇女被转诊到我们医院。她得了紫癜,外周嗜酸性粒细胞增多(18,177/μL),和升高的血清IgG4水平(819mg/dL)。腹部计算机断层扫描显示大量腹水和肠水肿。紫癜的皮肤活检显示白细胞碎裂性血管炎伴明显的嗜酸性粒细胞浸润。胃肠粘膜活检显示密集的嗜酸性粒细胞浸润，提示与嗜酸性粒细胞增多综合征相关的嗜酸性粒细胞性胃肠炎（EG）。十二指肠粘膜中IgG4阳性细胞的数量增加；然而，未达到IgG4相关疾病(IgG4-RD)的诊断标准.EG伴腹水是否是IgG4-RD的表现值得进一步研究。
