暴露于IgE正常的生海鲜后持续无症状嗜酸性粒细胞增多症：病例报告
Persistent asymptomatic eosinophilia after raw seafood exposure with normal IgE: a case report.
摘要(中文译文)
海洋海产品来源的异尖科线虫（例如，spp. 和 spp. [spp.]）可能引起胃肠道和过敏表现。在此，我们报告一例不寻常的病例：在摄入生食或轻度腌制的海产品后出现持续性、无症状的外周血嗜酸性粒细胞增多，提示亚临床抗原刺激的可能性。患者完全无症状，总IgE水平正常，寄生虫血清学（包括广州管圆线虫IgG）阴性，却出现了显著的嗜酸性粒细胞增多。患者童年有过敏性疾病史，成年后完全缓解，这可能代表与该显著嗜酸性粒细胞增多伴总IgE持续正常的异常表现相关的免疫学背景。尽管 underlying 机制无法直接证实，但这一模式提示以嗜酸性粒细胞为主的2型反应而无明显体液过敏表现的可能性。嗜酸性粒细胞计数在数月内持续升高，治疗前明显高于成人参考上限，而对寄生虫感染、感染性疾病和自身免疫性疾病的全面评估均为阴性。骨髓检查显示反应性嗜酸性粒细胞增生，影像学检查无异常。经验性阿苯达唑治疗后，嗜酸性粒细胞计数迅速恢复正常。这一时间关联支持但不能诊断该不明原因病例中存在寄生虫相关或抗原介导的触发因素。这一观察与最新的英国嗜酸性粒细胞增多症调查与管理指南一致，该指南建议对无明确病因的无症状患者考虑经验性驱虫治疗。本病例提示，对于其他方面原因不明的无症状嗜酸性粒细胞增多患者，在病史采集中即使仅有遥远且有限的生食或轻度腌制海产品摄入史也不应忽视，经验性驱虫治疗在部分病例中可能具有实际的诊断和治疗价值。
Abstract
Marine seafood-derived anisakid nematodes (e.g., spp. and spp. [ spp.]) may cause gastrointestinal and allergic manifestations. Here, we report an unusual case of persistent, asymptomatic peripheral eosinophilia following ingestion of raw or lightly marinated seafood, raising the possibility of subclinical antigenic stimulation. The patient remained entirely asymptomatic with normal total IgE levels, and parasite serology (including Angiostrongylus cantonensis IgG) was negative, yet developed marked eosinophilia. The patient had a childhood history of allergic diseases that fully resolved in adulthood, which may represent an immunologic background relevant to the unusual presentation of marked eosinophilia with persistently normal total IgE. Although the underlying mechanism could not be directly demonstrated, this pattern raises the possibility of a predominantly eosinophil-associated type 2 response without a prominent humoral allergic manifestation. The eosinophil count remained persistently elevated over several months and stayed markedly above the adult upper reference limit before treatment, while comprehensive evaluations for parasitic infection, infectious disease, and autoimmune conditions were negative. Bone marrow findings demonstrated reactive eosinophilic hyperplasia, and imaging studies were unremarkable. Following empiric albendazole therapy, the eosinophil count rapidly returned to normal. This temporal association was supportive of, but not diagnostic for, a parasite-related or antigen-mediated trigger in this otherwise unexplained case. This observation aligns with the latest UK Guideline for the Investigation and Management of Eosinophilia, which recommends considering empiric anthelmintic therapy in asymptomatic patients without an identifiable cause. This case suggests that in patients with otherwise unexplained asymptomatic eosinophilia, even a remote and limited history of consuming raw or lightly marinated seafood should not be overlooked during history taking, and that empiric anthelmintic therapy may offer practical diagnostic and therapeutic value in selected cases.
如何引用
AMA
Wen He, Juzhang Li, Jianfeng Zhang, Qiaozhen Wu. Persistent asymptomatic eosinophilia after raw seafood exposure with normal IgE: a case report.. Frontiers in immunology. 2026; doi:10.3389/fimmu.2026.1804368.
APA
Wen He, Juzhang Li, Jianfeng Zhang, Qiaozhen Wu (2026). Persistent asymptomatic eosinophilia after raw seafood exposure with normal IgE: a case report.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1804368
GB/T 7714
Wen He, Juzhang Li, Jianfeng Zhang, Qiaozhen Wu. Persistent asymptomatic eosinophilia after raw seafood exposure with normal IgE: a case report.[J]. Frontiers in immunology, 2026 doi:10.3389/fimmu.2026.1804368.
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