Features Of Eosinophilic Gastroenteritis Research Articles

Eosinophilic gastroenteritis in the setting of colorectal neoplasia

Eosinophilic gastroenteritis is a rare inflammatory disease of one or more segments of the gastrointestinal tract. Clinical features vary depending on the site and layer of involvement. We present a case of a 61-year-old female with malignant colonic obstruction and several months of abdominal discomfort, nausea, and altered bowel habits. She had a colonic stent as a bridge to her definitive surgery. She continued to have diarrhea and abdominal discomfort until her definitive surgery. Interestingly, histopathology showed colonic cancer with segments of eosinophilic colitis. This is a unique case given the rarity of eosinophilic gastroenteritis and its potential predisposition to neoplastic disease. We review the clinical and pathological features of eosinophilic gastroenteritis and the possible linkage with colorectal cancer.

Clinical analysis of eosinophilic gastroenteritis in children

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

Clinical, endoscopic and histopathological features of eosinophilic gastroenteritis in 76 children

Objective To analyze the clinical, endoscopic and histopathological features of eosinophilic gastroenteritis (EG) in children. Methods A retrospective study of 76 children with EG was performed to analyze clinical symptoms, laboratory and imaging results, endoscopic and pathological features, status of Helicobacter pylori (H.pylori) infection, treatment and outcomes. Results The main clinical symptoms were abdominal pain in 55.3%(42/76) cases, vomiting in 39.5% (30/76) cases and hematochezia in 38.2% cases(29/76). The hemoglobin level decreased significantly in 34 cases (44.7%, 34/76). Peripheral blood eosinophil (EOS) count increased significantly in 9 cases (11.8%, 9/76) and EOS percentage increased significantly in 13 cases(17.1%, 13/76). Total serum IgE elevated in 32 cases (54.2%, 32/59). There were also 18 cases (36.7%, 18/49) positive in serum allergen-specific immunoglobulin E (sIgE) test and 25 cases (32.9%, 25/76) positive in fecal occult blood test. Among 51 cases of abdominal ultrasound examination, there were 7 cases of ascites, 4 cases of pelvis fluid and 3 cases of intestinal wall change. Endoscopic examination in 76 cases showed 63 cases (82.9%) of mucosal hyperemia/edema, 20 cases (26.3%) of ulceration, 17 cases (22.4%) of erosion, 11 cases (14.5%) of nodularity or hyperplasia and 9 cases (11.8%) of normal mucosa. The pathological examination showed mucosal inflammation with a large number of EOS infiltration(≥20 per HPF). There were 12 cases(15.8%, 12/76) of H. pylori infection. Among the 76 cases, clinical symptoms improved significantly in 74 patients after treatment with dietary allergen avoidance, anti-allergy medications, antacids, montelukast and corticosteroid, and the total efficacy was 97.4%. The efficacy of dietary allergen avoidance, anti-allergy medications, antacids and montelukast was 93.8%(61/65). The efficacy of corticosteroid was 86.7%(13/15). Conclusion The clinical manifestations and endoscopic characteristics of EG in children lack specificity. In terms of diagnosis, the elevated total serum IgE and the positive sIgE test may be taken as reference for the diagnosis of EG. The definite diagnosis is based on pathological examination(EOS infiltration≥20 per HPF). While in terms of treatment, dietary allergen exclusion, anti-allergy medications, antacids and montelukast are highly effective, which can be taken as the first option. There is no need of corticosteroid as routine therapy. Key words: Endoscopy; Histopathology; Child; Eosinophilic gastroenteritis

Eosinophilic gastroenteritis: A case report with review of the literature

Eosinophilic gastroenteritis (EG) is a heterogenous disorder affecting adults, and is characterized by the presence of eosinophilic infiltration in the gastrointestinal tract. The clinical features of EG are related to the layers and extent of bowel involved from the esophagus to the colon. The diagnosis is typically confirmed by biopsy, which should reveal 20-25 eosinophils per high-power field on microscopic examination. We report a 38-year-old man who presented with a 2-month history of dyspeptic symptoms. On examination, he was found to have only moderate ascites. The investigations revealed peripheral eosinophilia with markedly elevated eosinophils (95%) in the ascitic fluid. The imaging studies showed diffuse concentric bowel wall thickening involving the entire small bowel. The diagnosis was confirmed by biopsy from the antrum of the stomach. The patient was managed with steroids.