嗜酸性粒细胞食管炎并发阿司匹林加重的呼吸道疾病:病例报告。

IF 1 Q3 MEDICINE, GENERAL & INTERNAL Cureus Pub Date : 2024-11-25 eCollection Date: 2024-11-01 DOI:10.7759/cureus.74384
Eiichi Kakehi, Kazuhiko Kotani
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引用次数: 0

摘要

一名 59 岁的妇女在服用非甾体抗炎药(NSAIDs)治疗上腹痛后突然出现呼吸困难。她有产后支气管哮喘病史。计算机断层扫描显示双侧外周支气管壁增厚、管腔狭窄、阻塞和周缘食管下段粘膜水肿。患者被诊断为阿司匹林加重呼吸道疾病(AERD),这是一种超敏反应。静脉注射地塞米松后,呼吸道症状有所改善。内镜检查证实食管下段粘膜水肿;粘膜活检发现嗜酸性粒细胞浸润,提示为嗜酸性粒细胞性食管炎(EoE)。虽然嗜酸性粒细胞食管炎通常是在急性食管炎之后被诊断出来的,但该患者在服用非甾体抗炎药后同时被诊断出患有急性食管炎和嗜酸性粒细胞食管炎。因此,当因腹部症状服用非甾体抗炎药后出现嗜酸性粒细胞食管炎时,应将嗜酸性粒细胞食管炎视为潜在的合并症。
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Aspirin-Exacerbated Respiratory Disease Complicated by Eosinophilic Esophagitis: A Case Report.

A 59-year-old woman developed sudden dyspnea after taking non-steroidal anti-inflammatory drugs (NSAIDs) for epigastralgia. She had a history of bronchial asthma after childbirth. Computed tomography showed bilateral peripheral bronchial wall thickening, lumen narrowing, obstruction, and circumferential lower esophageal mucosal edema. The patient was diagnosed with aspirin-exacerbated respiratory disease (AERD), a hypersensitivity reaction. Respiratory symptoms improved with intravenous dexamethasone. Endoscopy confirmed lower esophageal mucosal edema; mucosal biopsy detected eosinophilic infiltration, suggesting eosinophilic esophagitis (EoE). Although EoE is often diagnosed after AERD, the patient was simultaneously diagnosed with AERD and EoE after taking NSAIDs. Thus, EoE should be considered as a potential comorbidity when AERD develops after NSAID administration for abdominal symptoms.

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