Nonepisodic Angioedema Associated with Eosinophilia の7例  [in Japanese] Seven Cases of Nonepisodic Angioedema Associated with Eosinophilia  [in Japanese]

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Abstract

Nonepisodic angioedema associated with eosinophilia(NEAE)は著明な好酸球増多を伴う,反復しない手・下腿の血管浮腫を特徴とする。今回,NEAEの7症例の臨床像・病理組織および検査成績の特徴をまとめて記載する。共通する特徴として全例若い女性であり,紅斑や痒みなどの先行症状を認め,LDHの上昇を認め,IgMは正常範囲内であり,少量のステロイド内服で速やかに症状は軽快し,再燃はみられなかった。病理組織学的には真皮及び脂肪織に様々な程度で好酸球浸潤を認めた。また,初診時に好酸球数はピークには達しておらず,1週間後の採血時にピークを認めた症例があった。硬性で指圧痕を残さない,また発赤や局所熱感などがない下腿浮腫をみたときはangioedema associated with eosinophiliaを念頭に置き,好酸球数やLDHのチェックを行う。浮腫出現直後は好酸球がピークになっていないこともあるので,angioedema associated with eosinophiliaが疑われ,好酸球増多を認めない場合は7日後から10日後に好酸球数をもう一度チェックすべきである。

Nonepisodic angioedema associated with eosinophilia (NEAE) is characterized by non-recurrent angioedema of the hands and lower legs with a remarkable eosinophilia. In this report, we describe 7 cases of NEAE to delineate the clinical, pathological and laboratory features of NEAE. The common features of these 7 cases included: (i) predominance of young women, (ii) initial symptoms such as erythema or itching, (iii) increase in serum LDH level and absence of increased serum IgM level, (iv) effectiveness of low-dose prednisolone, (v) lack of recurrence, and (vi) various histological findings from marked infiltration of eosinophils in the deeper dermis to slight infiltration of eosinophils in adipose tissue. In 2 cases, the eosinophil count did not reach a peak at the initial visit, but did peak seven days later. When we see a patient with non-pitting edema of the lower legs and feet without redness or calor, we should keep angioedema associated with eosinophilia (AE) in mind. If AE is suspected without remarkable eosinophilia, the eosinophil count should be examined again after 7 to 10 days because it may not have peaked early in the course of AE.

Journal

  • Nishi Nihon Hifuka

    Nishi Nihon Hifuka 69(1), 11-17, 2007-02-01

    Western Division of Japanese Dermatological Association

References:  11

Codes

  • NII Article ID (NAID)
    10019967608
  • NII NACSIS-CAT ID (NCID)
    AN00183881
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    03869784
  • NDL Article ID
    8672246
  • NDL Source Classification
    ZS39(科学技術--医学--皮膚科学・泌尿器科学)
  • NDL Call No.
    Z19-69
  • Data Source
    CJP  NDL  J-STAGE 
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