木村病是持续性嗜酸性粒细胞增多症的罕见病因:诊断挑战。

IF 3.8 3区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Biochemia Medica Pub Date : 2023-06-15 DOI:10.11613/BM.2023.020801
Javier Laguna, María Rodríguez-García, Angel Molina, Anna Merino
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引用次数: 0

摘要

木村病是一种病因不明的罕见炎症性疾病。尽管在许多年前就被描述过,但KD可能会导致诊断困难或与其他疾病混淆。在这里,我们提出一个33岁的菲律宾妇女谁被转介到我们医院评估持续嗜酸性粒细胞增多和强烈的瘙痒。血液分析和外周血涂片检查显示高嗜酸性粒细胞计数(3.8 x109/L, 40%),未显示形态异常。血清IgE浓度较高(33,528 kU/L)。犬弓形虫血清学检测呈阳性,于是开始用阿苯达唑治疗。然而,几个月后,嗜酸性粒细胞计数仍然增加,同时血清IgE浓度高,瘙痒强烈。在随访中,发现腹股沟腺病。活检显示淋巴增生伴生发中心反应性增生和大量嗜酸性粒细胞浸润。还观察到嗜酸性物质的蛋白质沉积。所有这些结果,加上外周血嗜酸性粒细胞增多和高IgE浓度,证实了KD的诊断。KD的诊断应考虑在鉴别诊断长期不明原因嗜酸性粒细胞增多症与高IgE浓度,瘙痒和淋巴结病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Kimura disease as an uncommon cause of persistent hypereosinophilia: a diagnostic challenge.

Kimura disease (KD) is an unusual inflammatory disease of unknown etiology. Despite being described many years ago, KD might cause diagnostic difficulty or be confused with other conditions. Here, we present a 33-year-old Filipino woman who was referred to our hospital for evaluation of persistent eosinophilia and intense pruritus. Blood analysis and peripheral blood smear review showed high eosinophil counts (3.8 x109/L, 40%) that did not show morphological abnormalities. Besides, high serum IgE concentration was detected (33,528 kU/L). Serological tests were positive for Toxocara canis and treatment with albendazol was initiated. Nevertheless, increased eosinophil counts were still present after several months, alongside with high serum IgE concentrations and intense pruritus. During her follow-up, an inguinal adenopathy was detected. The biopsy revealed lymphoid hyperplasia with reactive germinal centers and massive eosinophil infiltration. Proteinaceous deposits of eosinophilic material were also observed. All these findings, together with peripheral blood eosinophilia and high IgE concentrations, confirmed the diagnosis of KD. The diagnosis of KD should be considered in the differential diagnosis of long-standing unexplained eosinophilia in association with high IgE concentrations, pruritus and lymphadenopathies.

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来源期刊
Biochemia Medica
Biochemia Medica 医学-医学实验技术
CiteScore
5.50
自引率
3.00%
发文量
70
审稿时长
>12 weeks
期刊介绍: Biochemia Medica is the official peer-reviewed journal of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Journal provides a wide coverage of research in all aspects of clinical chemistry and laboratory medicine. Following categories fit into the scope of the Journal: general clinical chemistry, haematology and haemostasis, molecular diagnostics and endocrinology. Development, validation and verification of analytical techniques and methods applicable to clinical chemistry and laboratory medicine are welcome as well as studies dealing with laboratory organization, automation and quality control. Journal publishes on a regular basis educative preanalytical case reports (Preanalytical mysteries), articles dealing with applied biostatistics (Lessons in biostatistics) and research integrity (Research integrity corner).
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