W1914 Clinical Features of Eosinophilic Colitis – A Report of 7 Consecutive Cases

Abstract

Background: Primary eosinophilic gastrointestinal disease (EGID) is a rare spectrum of gastrointestinal disorders that primarily affects the gastrointestinal tract. EGID causes inflammation rich in eosinophilic cells in the absence of known causes for eosinophilia. Eosinophilic colitis (EC) represents the least frequent manifestation of EGID and it is unknown whether it represents an independent group of diseases. Methods: The pathology database of the Calgary Health Region was used to identify all cases of EGID and EC. The medical records of all seven patients diagnosed with EC in the Calgary Health Region from 1996-2008 were retrospectively reviewed and the diagnosis was again confirmed by an expert pathologist. Results: The median age of presentation was 42 years. Four patients (57.1%) were females and three (42.9%) were males. Abdominal pain was present in six patients (85.7%), nonbloody diarrhea in four patients (57.1%), bloody diarrhea in two (28.6%) and two patients (28.6%) had more than 10% significant weight loss. Four patients (57.1%) reported a history of drug allergies indicating a predisposition towards allergic diseases but in none of the patients a distinct allergy causing EC was identified. Two patients (28.6%) were on non steroidal anti-inflammatory drugs at diagnosis. One patient (14.3%) was found to have additional peripheral eosinophilia. On histology, all patients had eosinophilic infiltrate in the Lamina propria, two (28.6%) had additional Muscularis propria infiltrate, and four patients (57.1%) had cryptitis. Conclusion: EC is a rare medical condition with different patterns of presentations. A high index of suspicion is needed to diagnose this disease. Pathology plays a crucial rule in diagnosis and colonic biopsies are important to rule out EC for the indication diarrhea.