Abstract
Background Eosinophilic gastroenteritis (EGE) is an uncommon disease characterized by eosinophilic infiltration of the digestive tract, which occurs due to an uncertain aetiology. Although autoimmune diseases can later present as EGE, it is unusual for EGE to have positive autoimmune antibodies without the presence of an overt autoimmune disease. Case presentation. We report a 38-year-old previously healthy man who presented with abdominal discomfort and loose stools with pleural and peritoneal effusions progressing over several weeks. His investigations revealed severe eosinophilia in peripheral blood and ascitic fluid, and a laparoscopic full-thickness biopsy from the ileum demonstrated infiltration of eosinophils in all three layers of the intestine. There were no clinical features or investigations suggestive of parasitic disease, other diseases associated with eosinophilia, or autoimmune disease. Further investigations showed a highly positive ANA, positive p-ANCA, but did not meet the criteria to diagnose a specific autoimmune disease. The eosinophilia responded to an elimination diet with gradual resolution of eosinophilia and effusions, and once it reappeared after introduction of a normal diet. Conclusion EGE presenting as peripheral blood and ascitic fluid eosinophilia with the presence of pleural and/or peritoneal effusions is uncommon. Eosinophilic gastroenteritis can be associated with autoantibody positivity without any evidence of overt autoimmune disease manifestations. Elimination diet can be used as a potential option to prevent recurrences of EGE.
Highlights
Eosinophilic gastroenteritis (EGE) is an uncommon disease characterized by eosinophilic infiltration of the digestive tract, which occurs due to an uncertain aetiology
Eosinophilic gastroenteritis (EGE) is a rare inflammatory disease characterized by eosinophilic infiltration of the digestive tract [1], with an approximate prevalence ranging from 1 in 100,000 to 28 in 100,000 population in different studies [2, 3]
One of the major reasons that make this presentation unique is the positivity of markers of autoimmunity with a significant ANA titer, positive rheumatoid factor, positive p-ANCA, in the absence of autoimmune disease up to 2 years of follow-up. ough eosinophilic gastroenteritis has been diagnosed in a significant number of patients presenting with gastrointestinal symptoms, it has been described rarely to be associated with rheumatological conditions including rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis, Sjogren’s syndrome, overlap syndromes [12], polymyositis, and scleroderma [13, 14]
Summary
Eosinophilic gastroenteritis (EGE) is a rare inflammatory disease characterized by eosinophilic infiltration of the digestive tract [1], with an approximate prevalence ranging from 1 in 100,000 to 28 in 100,000 population in different studies [2, 3]. Diagnosis of eosinophilic gastroenteritis requires three criteria to be met, which include clinical suspicion, histological evidence of eosinophilic infiltration of bowel, and exclusion of other pathological. E available dietary approaches include an exclusive elemental diet with an amino acid-based complete liquid formulation, an allergy test-directed elimination diet, and an empiric elimination diet that excludes common disease-triggering foods. We report a rare presentation of a patient diagnosed to have eosinophilic gastroenteritis who had positive autoimmune markers and showed clinical and biochemical improvement with an elimination diet to maintain remission
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
