Neurology:多发性小梗死别忘了嗜酸性粒细胞增多症

2019-06-01 佚名 脑血管病及重症文献导读

56岁,免疫力正常女性。因为严重头痛和脑病就诊。

56岁,免疫力正常女性。

因为严重头痛和脑病就诊。

MRI 显示大脑半球和小脑大量点样梗死:



血白细胞计数未18500,97%嗜酸性粒细胞。感染、肿瘤筛查,包括脑脊液和骨穿皆未见异常。

住院期间并发嗜酸性粒细胞肺炎,心肌梗塞,和深静脉血栓形成。发现心内膜纤维化。

诊断为特发性嗜酸性粒细胞增多综合征(Idiopathic hypereosinophilic syndrome,IHES)。

IHES是一种白细胞增生性疾病,会引起多脏器损害。诊断该病需要具备外周血嗜酸性粒细胞显着升高,并排除感染血液恶性肿瘤和血管炎。IHES 患者的脑梗死是由于分水岭区域微血管发生闭塞造成的。

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    2019-08-19 yinhl1978
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    2019-11-21 jml2009
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