Clinical analysis of eosinophilic gastroenteritis in children

Abstract

Objective To discuss the clinical manifestations, laboratory indexes, imageological examination results, endoscopic and histopathological features of eosinophilic gastroenteritis(EG) in children. Methods Thirty-three children with EG were collected with clinical manifestations, allergic history, laboratory examination, endoscopic and histopathological features and treatments, who were hospitalized at department of pediatric gastroenterology of Shengjing Hospital of China Medical University between January 2012 and December 2017. Results The main clinical manifestations of EG were abdominal pain(75.8%), vomiting(30.3%)and diarrhea(21.2%). The hemoglobin level decreased in 7 cases(21.2%). The eosinophil count increased in 13 cases(39.4%). Total serum IgE elevated in 18 cases(54.5%), while 23 cases were positive in serum food or respiratory specific IgE.The fecal occult blood test showed positive in 7 cases(21.2%). Among 28 children conducted with whole abdominal CT, there were 13 cases of pelvis fluid, 12 cases of enlarged lymph nodes and 4 cases of thickened intestinal wall.All 33 children went through the endoscopic examination, the main histological change were erythema-exudation(31 cases, 93.9%), mucosal hyperemia edema(5 cases, 15.2%) and hemorrhage(4 cases, 12.1%). The main pathological change was mucosal inflammation with a large number of eosinophil infiltration(≥20 per HPF). Among the 33 cases, 17 cases relieved through treatment of avoiding allergen, antacids, anti-allergic agents and leukotriene receptor antagonist, with 1 case recurrence.The other 16 cases relieved after treatment of glucocorticoid and the above therapy, with 3 cases recurrence. Conclusion The clinical manifestations of children with EG are various and lack of specificity.In terms of diagnosis, the elevated level of eosinophil count and total serum IgE, or positive in serum food specific IgE may be taken as reference.The definite diagnosis is based on pathological examination (eosinophil infiltration≥20 per HPF). For treatment, avoiding allergen, antacids, anti-allergic agents and leukotriene receptor antagonist are effective in several children.Glucocorticoid can obtain satisfactory curative effect in the uneffective children. Key words: Eosinophilic gastroenteritis; Children; Clinical features; Endoscopy