非阵发性血管性水肿伴嗜酸性粒细胞增多症与年轻女性嗜酸性粒细胞增多症的鉴别诊断

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal Pub Date : 2024-10-24 DOI:10.1016/j.waojou.2024.100981

Yura Ha BS , Min Ju Pyo MS , Ye Eun Hong BS , So Hye Nam MD , Woo-Jung Song MD, PhD , Hyouk-Soo Kwon MD, PhD , Tae-Bum Kim MD, PhD , Yoo Sook Cho MD, PhD , Ji-Hyang Lee MD, PhD

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引用次数: 0

摘要

背景嗜酸性粒细胞增多的阵发性血管性水肿又称格莱希综合征，是反复发作的血管性水肿患者血液中嗜酸性粒细胞增多的鉴别诊断之一。与此同时，关于非阵发性血管性水肿伴嗜酸性粒细胞增多症（NEAE）的研究较少。本研究旨在探讨 NEAE 的发病率、临床特征和病程。方法通过查阅电子病历，我们在牙山医疗中心 2021 年 1 月至 2023 年 12 月期间因嗜酸性粒细胞增多症转诊至过敏诊所的患者中发现了 NEAE 患者。结果在 687 名嗜酸性粒细胞增多症患者中，有 58 人（8.4%）被诊断为 NEAE 并接受了治疗。所有患者均为女性，平均年龄为 31.79 岁。血液中嗜酸性粒细胞绝对计数的平均值为 4468.76 cells/μL。所有患者的小腿都出现了对称性血管性水肿，37 名患者（63.8%）的上臂也出现了血管性水肿。25名患者（43.1%）报告在出现血管性水肿前曾有过类似症状。所有患者均接受了全身皮质类固醇治疗（平均总剂量为 1745 ± 508.49 毫克），治疗时间约为 40 天。结论嗜酸性粒细胞增多症是年轻女性嗜酸性粒细胞增多症患者，尤其是伴有对称性周围血管性水肿患者的重要鉴别诊断。

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Non-episodic angioedema with eosinophilia as a differential diagnosis of eosinophilia in young females

Background

Episodic angioedema with eosinophilia, also known as Gleich's syndrome, is a differential diagnosis in patients with recurrent angioedema with higher blood eosinophils. Meanwhile, less has been elucidated regarding non-episodic angioedema with eosinophilia (NEAE). This study aimed to examine the prevalence, clinical characteristics, and disease course of NEAE.

Methods

By reviewing the electronic medical records, we identified patients with NEAE among those referred to allergy clinics due to eosinophilia from January 2021 to December 2023 at Asan Medical Center.

Results

Among 687 patients with eosinophilia, 58 (8.4%) were diagnosed with and treated for NEAE. All patients were females, with a mean age of 31.79 years. The mean absolute blood eosinophil count was 4468.76 cells/μL. All patients reported symmetric angioedema of the lower legs, and 37 (63.8%) had additional angioedema of the upper arms. Twenty-five (43.1%) patients reported a preceding event prior to onset of angioedema. Systemic corticosteroids (mean total dose 1745 ± 508.49 mg) were prescribed to all patients, with a treatment duration of approximately 40 days to achieve resolution. Following the resolution of angioedema, 6 patients experienced persistent arthralgia, 1 developed chronic spontaneous urticaria, and 1 developed hypereosinophilic syndrome.

Conclusions

NEAE is an essential differential diagnosis in young female patients with eosinophilia, particularly those presenting with symmetric peripheral angioedema.

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来源期刊

World Allergy Organization Journal Immunology and Microbiology-Immunology

CiteScore

9.10

自引率

5.90%

发文量

审稿时长

9 weeks

期刊介绍： The official pubication of the World Allergy Organization, the World Allergy Organization Journal (WAOjournal) publishes original mechanistic, translational, and clinical research on the topics of allergy, asthma, anaphylaxis, and clincial immunology, as well as reviews, guidelines, and position papers that contribute to the improvement of patient care. WAOjournal publishes research on the growth of allergy prevalence within the scope of single countries, country comparisons, and practical global issues and regulations, or threats to the allergy specialty. The Journal invites the submissions of all authors interested in publishing on current global problems in allergy, asthma, anaphylaxis, and immunology. Of particular interest are the immunological consequences of climate change and the subsequent systematic transformations in food habits and their consequences for the allergy/immunology discipline.