Abstract
Acute eosinophilic appendicitis (AEA) is a rare variant of appendix inflammation possibly linked to allergy. Histopathological evidence of eosinophilic infiltration of the muscularis propria and edema separating the muscle fibers is the gold standard for the diagnosis. Here, we report a case of a young boy with AEA following a skin reaction of possible allergic origin. A 6-year-old male was presented to the emergency department with a two-day diffuse abdominal pain and tenderness in the right lower quadrant. A possible allergic reaction had occurred five days before as a pruritic rash. There was no history of allergy and the stool examination was negative for parasites. The initial diagnosis was acute appendicitis, and appendectomy was performed. The histopathological diagnosis was AEA. Further studies on the proper diagnostic and treatment approach of AEA before surgery are required.
Highlights
Acute eosinophilic appendicitis (AEA) and there are only four cases of children with no history of Conflict of interest: the authors declare no potential conflict of interest
No hematological tests were performed because there was no previous history of allergy or atopy in the child and there was no relation to exposure to possible allergens
We describe a young boy with no previous history of allergy, with histopathological findings of AEA and a pruritic skin rash five days prior to admission
Summary
A previous report mentioned that AEA may be related to EGE where the eosinophilic infiltration can affect any part of the gastrointestinal tract.[16] The differences between AEA and EGE are the following: i) EGE is more common among children younger than five-year-old while the AEA commonly seen in older patients;[17] ii) EGE has usually more dramatic presentation with abdominal pain, abdominal distention, vomiting, diarrhea, malabsorption, weight loss, eosinophilic ascites and can lead to serious complications such as intestinal obstruction and perforation;[17] iii) many patients (52% of children and 41.8% of adults) with EGE have a history of allergy;[17] and iv) EGE involves peripheral blood eosinophilia in contrast with the AEA where the eosinophils count is normal.[16].
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