Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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A Case of Eosinophilic Gastroenteritis Presenting with Fever and Multiple Lymphadenopathy

발열과 림프절 병증을 동반한 호산구 위창자염 1예

  • Kang, Bo-Ra-Mi (Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea) ;
  • Chung, Woo-Chul (Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Kang-Moon (Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea) ;
  • Paik, Chang-Nyol (Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Ji-Min (Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jeon, Hyo-Sin (Department of Surgery, St. Vincent Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jun, Kyong-Hwa (Department of Surgery, St. Vincent Hospital, College of Medicine, The Catholic University of Korea) ;
  • Chin, Hyung-Min (Department of Surgery, St. Vincent Hospital, College of Medicine, The Catholic University of Korea)
  • 강보라미 (가톨릭대학교 의과대학 성빈센트병원 내과학교실) ;
  • 정우철 (가톨릭대학교 의과대학 성빈센트병원 내과학교실) ;
  • 이강문 (가톨릭대학교 의과대학 성빈센트병원 내과학교실) ;
  • 백창렬 (가톨릭대학교 의과대학 성빈센트병원 내과학교실) ;
  • 이지민 (가톨릭대학교 의과대학 성빈센트병원 내과학교실) ;
  • 전효신 (가톨릭대학교 의과대학 성빈센트병원 외과학교실) ;
  • 전경화 (가톨릭대학교 의과대학 성빈센트병원 외과학교실) ;
  • 진형민 (가톨릭대학교 의과대학 성빈센트병원 외과학교실)
  • Published : 2011.06.30
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Abstract

Eosinophilic gastroenteritis is an unusual disease that is associated with various clinical gastrointestinal manifestations. Its severity depends on the area involved as well as the wall layer involved. Eosinophilic gastroenteritis often causes abdominal pain, nausea, vomiting and diarrhea. To date, there has been an extremely rare case of eosinophilic gastroenteritis with systemic symptoms, such as fever or lymphadenopathy (LAP). We experienced a case of a 68-year-old-woman with fever and abdominal pain. Abdominal computed tomography revealed diffuse wall thickening of the gastric antrum as linitis plastica. Multiple hot uptakes of lymph nodes were visualized on fludeoxyglucose-positron emission tomography. The gastric biopsy pathological report demonstrated eosinophilic infiltration without malignant cells. We could not exclude malignancy and performed an exploratory laparoscopy. A lymph node specimen showed reactive hyperplasia, and her illness was finally diagnosed as eosinophilic gastroenteritis. Herein, we report the case with a brief review.

호산구 위창자염은 비교적 드문 질환으로 다른 원인 없이 위장관에 호산구의 침윤을 특징으로 한다. 여러 가지 임상증상이 나타나는데 주로 복통, 설사, 오심 및 구토이고, 침범하는 기관이나 발생한 병변에서 호산구가 침윤되는 범위에 따라 다르게 나타난다. 현재까지 발열이나 림프절 병증과 같은 전신 증상을 동반하는 호산구 위창자염은 매우 드물다고 알려져 있다. 저자들은 68세 여자에서 발열과 복통으로 발현한 호산구 위창자염을 경험하였다. 복부 CT에서 위전정부의 벽 비후 소견을 보였고, PET에서 다수의 림프절 종대와의 FDG의 고섭취가 관찰되었다. 상부위장관내시경을 통한 위 점막의 조직검사에서 악성세포는 보이지 않았지만 다수의 호산구 침윤을 관찰할 수 있었다. 위의 악성 종양을 배제하기 위하여 시험적 복강경을 통한 림프절 조직검사를 시행하였고, 반응성 비대를 보여 최종적으로 호산구 위창자염으로 진단하였다.

Keywords

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