Eosinophilic Gastroenteritis Due To Egg Allergy Presenting As Acute Pancreatitis

Abstract

RationaleEosinophilic gastroenteritis (EGE) is a disease characterized by eosinophilic infiltration of the gastrointestinal tract. Most patients present with nonspecific symptoms of gastrointestinal pain, bloating, nausea, vomiting, diarrhea, malabsorption and ascites. Here we present a case of acute pancreatitis in a 25 year-old female within 1 hour after ingestion of an egg-containing product.MethodsSerologic testing by Immunocap performed to commonly allergic foods. Endoscopy performed during admission for acute pancreatitis.ResultsDuring one of these attacks, her lipase was elevated to 2400 U/L. Endoscopic biopsies revealed increased eosinophils in the duodenum without villous blunting or acute inflammation. Charcot Leyden crystals were also noted on a stool sample. In vitro allergy testing demonstrated a level III sensitization to egg, all other tested foods were negative. Removal of egg from this patient’s diet has lead to complete resolution of her symptoms.ConclusionsOne previous case report discussed a patient with milk allergy resulting in EGE with acute pancreatitis. A possible mechanism by which food-hypersensitivity related EGE may cause acute pancreatitis is due to obstruction of the pancreatic duct from local duodenal inflammation. When unexplainable gastrointestinal symptoms are observed in patients with positive food allergy testing, EGE triggered by food allergies should be included in the diagnosis. RationaleEosinophilic gastroenteritis (EGE) is a disease characterized by eosinophilic infiltration of the gastrointestinal tract. Most patients present with nonspecific symptoms of gastrointestinal pain, bloating, nausea, vomiting, diarrhea, malabsorption and ascites. Here we present a case of acute pancreatitis in a 25 year-old female within 1 hour after ingestion of an egg-containing product. Eosinophilic gastroenteritis (EGE) is a disease characterized by eosinophilic infiltration of the gastrointestinal tract. Most patients present with nonspecific symptoms of gastrointestinal pain, bloating, nausea, vomiting, diarrhea, malabsorption and ascites. Here we present a case of acute pancreatitis in a 25 year-old female within 1 hour after ingestion of an egg-containing product. MethodsSerologic testing by Immunocap performed to commonly allergic foods. Endoscopy performed during admission for acute pancreatitis. Serologic testing by Immunocap performed to commonly allergic foods. Endoscopy performed during admission for acute pancreatitis. ResultsDuring one of these attacks, her lipase was elevated to 2400 U/L. Endoscopic biopsies revealed increased eosinophils in the duodenum without villous blunting or acute inflammation. Charcot Leyden crystals were also noted on a stool sample. In vitro allergy testing demonstrated a level III sensitization to egg, all other tested foods were negative. Removal of egg from this patient’s diet has lead to complete resolution of her symptoms. During one of these attacks, her lipase was elevated to 2400 U/L. Endoscopic biopsies revealed increased eosinophils in the duodenum without villous blunting or acute inflammation. Charcot Leyden crystals were also noted on a stool sample. In vitro allergy testing demonstrated a level III sensitization to egg, all other tested foods were negative. Removal of egg from this patient’s diet has lead to complete resolution of her symptoms. ConclusionsOne previous case report discussed a patient with milk allergy resulting in EGE with acute pancreatitis. A possible mechanism by which food-hypersensitivity related EGE may cause acute pancreatitis is due to obstruction of the pancreatic duct from local duodenal inflammation. When unexplainable gastrointestinal symptoms are observed in patients with positive food allergy testing, EGE triggered by food allergies should be included in the diagnosis. One previous case report discussed a patient with milk allergy resulting in EGE with acute pancreatitis. A possible mechanism by which food-hypersensitivity related EGE may cause acute pancreatitis is due to obstruction of the pancreatic duct from local duodenal inflammation. When unexplainable gastrointestinal symptoms are observed in patients with positive food allergy testing, EGE triggered by food allergies should be included in the diagnosis.