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好酸球性胃腸炎の診断フローチャート

出典
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1: 著者提供

Tallyらの好酸球性胃腸炎の診断基準

Tallyらは好酸球性胃腸炎の診断基準として以上の3項目を挙げている。
出典
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1: Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues.
著者: N J Talley, R G Shorter, S F Phillips, A R Zinsmeister
雑誌名: Gut. 1990 Jan;31(1):54-8.
Abstract/Text: The aim of this study was to evaluate the clinicopathological spectrum of eosinophilic gastroenteritis and identify possible difficulties in establishing the diagnosis. All patients with a diagnosis of eosinophilic gastroenteritis, defined by the presence of gastrointestinal symptoms and eosinophilic infiltration of the gut (38), or a radiological diagnosis with peripheral eosinophilia (two), were identified from the Mayo Clinic records; in none was there evidence of extraintestinal disease. Patients were divided into three groups according to the Klein classification: predominant mucosal (23), muscular (12), or subserosal disease (five). A fourth group of patients (10) for comparison had abdominal symptoms and unexplained peripheral eosinophilia but no proven eosinophilic infiltration of the gut. It was found that a history of allergy was reported by 20 of 40 patients with eosinophilic gastroenteritis. Peripheral eosinophilia was absent in nine of 40. The patients with subserosal disease were distinct from the other groups in presentation (abdominal bloating, ascites), higher eosinophil counts and in their dramatic responses to steroid therapy. Otherwise the patients were similar regarding demographic factors, presenting symptoms (abdominal pain, nausea, weight loss, diarrhoea), and laboratory parameters. The ESR was moderately raised in 10 of 40 patients. The disease may affect any area of the gastrointestinal tract; eosinophilic infiltration was documented in the oesophagus in one patient and in the colon in two cases. Endoscopic biopsies missed the diagnosis in five of 40 presumably because of patchy disease. Eosinophilic gastroenteritis should be considered in the differential diagnosis of unexplained gastrointestinal symptoms even in the absence of peripheral eosinophilia.
Gut. 1990 Jan;31(1):54-8.

好酸球性胃腸炎の診断指針

出典
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1: 好酸球性消化管疾患、重症持続型の根本治療、多種食物同時除去療法に関するエビデンス創出研究班.好酸球性消化管疾患(指定難病 98).難病情報センター; 2019. https://www.nanbyou.or.jp/entry/3935.(閲覧日 2021/10/21)

好酸球性胃腸炎の大腸内視鏡写真

17歳女性。大腸粘膜に発赤、浮腫、潰瘍をみとめる。
出典
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1: 木下芳一, 石原俊二, 天野祐二, 清村志乃, 多田育賢, 丸山理留敬:好酸球性胃腸炎の診断と治療.日本消化器内視鏡学会雑 2012;54(6):1800.

好酸球性胃腸炎の大腸内視鏡写真

16歳女性。大腸粘膜に浮腫をみとめる。
出典
img
1: 木下芳一, 石原俊二, 天野祐二, 清村志乃, 多田育賢, 丸山理留敬:好酸球性胃腸炎の診断と治療.日本消化器内視鏡学会雑 2012;54(6):1800.

好酸球性胃腸炎の診断フローチャート

出典
img
1: 著者提供

Tallyらの好酸球性胃腸炎の診断基準

Tallyらは好酸球性胃腸炎の診断基準として以上の3項目を挙げている。
出典
imgimg
1: Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues.
著者: N J Talley, R G Shorter, S F Phillips, A R Zinsmeister
雑誌名: Gut. 1990 Jan;31(1):54-8.
Abstract/Text: The aim of this study was to evaluate the clinicopathological spectrum of eosinophilic gastroenteritis and identify possible difficulties in establishing the diagnosis. All patients with a diagnosis of eosinophilic gastroenteritis, defined by the presence of gastrointestinal symptoms and eosinophilic infiltration of the gut (38), or a radiological diagnosis with peripheral eosinophilia (two), were identified from the Mayo Clinic records; in none was there evidence of extraintestinal disease. Patients were divided into three groups according to the Klein classification: predominant mucosal (23), muscular (12), or subserosal disease (five). A fourth group of patients (10) for comparison had abdominal symptoms and unexplained peripheral eosinophilia but no proven eosinophilic infiltration of the gut. It was found that a history of allergy was reported by 20 of 40 patients with eosinophilic gastroenteritis. Peripheral eosinophilia was absent in nine of 40. The patients with subserosal disease were distinct from the other groups in presentation (abdominal bloating, ascites), higher eosinophil counts and in their dramatic responses to steroid therapy. Otherwise the patients were similar regarding demographic factors, presenting symptoms (abdominal pain, nausea, weight loss, diarrhoea), and laboratory parameters. The ESR was moderately raised in 10 of 40 patients. The disease may affect any area of the gastrointestinal tract; eosinophilic infiltration was documented in the oesophagus in one patient and in the colon in two cases. Endoscopic biopsies missed the diagnosis in five of 40 presumably because of patchy disease. Eosinophilic gastroenteritis should be considered in the differential diagnosis of unexplained gastrointestinal symptoms even in the absence of peripheral eosinophilia.
Gut. 1990 Jan;31(1):54-8.