Retraction: Eosinophilic Enteritis with Eosinophilic Ascites without Eosinophilia
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Eosinophilic enteritis is an uncommon disease of unknown cause characterized by eosinophilic infiltration in various areas of the gastrointestinal tract with symptoms. It is generally classified according to the layer of the gastrointestinal tract involved. Eosinophilic infiltration of the serosa is the rarest form of presentation and may manifest eosinophilic ascites. We report a case of a 47-year-old man who experienced progressing abdominal pain. A diffuse erythematous change of the gastric mucosa was observed on gastrofibroscopy. An abdominal computed tomography and colonoscopy showed diffuse wall thickening of the small bowel and colon with a small amount of ascites. Eosinophilic infiltration was confirmed by multiple biopsies of the gastrointestinal tract and peritoneal fluid analysis. The patient was treated with corticosteroid and respondedKeywords:
Eosinophilic gastroenteritis
Infiltration (HVAC)
Eosinophilic gastroenteritis
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A 49-year-old patient presented with urticaria, vomiting, diarrhea and peripheral eosinophilia. A histological diagnosis of eosinophilic gastroenteritis was made. Within 3 weeks of admission a highly papillary adenocarcinoma of the right ovary was diagnosed. The gastrointestinal symptoms and the eosinophilia disappeared after partial resection of the tumor and chemotherapy. A possible relationship between cancer, eosinophilia and eosinophilic gastroenteritis is discussed.
Eosinophilic gastroenteritis
Papillary adenocarcinoma
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A 30-year-old woman was admitted to our hospital because of ileus and ascites. Laboratory data on admission demonstrated marked eosinophilia (42.5% of WBC) but negative CRP-value. Abdominal CT showed marked ascites and diffuse thickening of intestinal walls. Ascites examination revealed eosinophilic ascites. The level of IL-5 both in the serum and in the ascites were also high. No evidence of eosinophilic infiltration was noted both gastric and colonic mucosal biopsy specimens. Oral prednisolone treatment (50 mg/day) was effective for her. We diagnosed her as a case of sub-serosal type eosinophilic gastroenteritis. It is essential to obtain eosinophilic ascites for correct diagnosis of the disease. And it is possible that serum and ascites IL-5 value would be reliable indicator of the activity of this disease.
Eosinophilic gastroenteritis
Ileus
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BACKGROUND:Eosinophilic gastroenteritis is a rare disease, characterized by infiltrates of eosinophils in the intestinal mucosa, muscularis propria, and serosa. Eosinophilic gastroenteritis is due to Type 1 hypersensitivity and can be associated with other atopic diseases. The clinical course of eosinophilic gastroenteritis varies depending on the location, extent, and depth of eosinophilic infiltration of the gastrointestinal tract, which can make the diagnosis challenging. A case of eosinophilic gastroenteritis associated with eosinophilic ascites is presented that emphasizes the importance of full-thickness intestinal biopsy, which includes the muscularis propria, to allow the definitive diagnosis to be made. CASE REPORT:A 28-year-old man presented with vague abdominal pain, nonspecific gastrointestinal symptoms, unintentional weight loss, and progressive ascites during the previous several months. A diagnosis of eosinophilic gastroenteritis was made after the exclusion of other possible causes, which was confirmed by histopathology of a full-thickness intestinal biopsy. The patient was treated with steroids. At one-month follow-up, the patient reported reduced abdominal pain. CONCLUSIONS:A case of eosinophilic gastroenteritis associated with eosinophilic ascites is presented that emphasizes the importance of full-thickness intestinal biopsy, which includes the muscularis propria, to allow the definitive diagnosis to be made.
Eosinophilic gastroenteritis
Histopathology
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症例は55歳男性．既往に喘息を認める．下痢と下腹部痛のため近医受診．半年で－６kgの体重減少も認めており，精査加療目的に当院を紹介受診．２時間毎の下痢と，増強する腹痛のため，同日入院した．腹部CT・USでは，胆石・胆泥を認めた．下部消化管内視鏡検査では，直腸から横行結腸にかけてやや浮腫状の発赤を散見し，生検の結果，好酸球性腸炎の診断となった．入院時の血液検査でも，好酸球増多症を認めていた．また，食後の心窩部痛も出現し，上部消化管内視鏡を施行したところ，胃潰瘍（H2）を認めた．好酸球性腸炎による下痢に対しては，整腸剤の内服によって改善したため，ステロイド内服は導入しなかった．その後，胆囊結石症に対し，腹腔鏡下胆囊摘出術を施行したところ，病理結果にて著明な好酸球浸潤を認め，好酸球性胆囊炎と診断した．また，最終的に，食道を除く，胃・十二指腸・胆囊・大腸・手術時に採取した腹水より好酸球浸潤を認めた．既往に喘息を有する消化管疾患では，好酸球性胆囊炎や好酸球性胃腸炎も念頭に置いて診療にあたる必要があると考えられた．
Eosinophilic gastroenteritis
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Eosinophilic gastroenteritis
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A young woman experienced twice in eight years acute, self-limited episodes of gastroenteritis with marked eosinophilia, each one associated with or triggered by a normal delivery. This patient had a normal gastric mucosal biopsy, thus lacking one of the major criteria required by previous authors for the definition of eosinophilic gastroenteritis. Nevertheless, it is our belief that this case does represent a milder and more benign form of the very same syndrome, associated in a dubious way with labour.
Eosinophilic gastroenteritis
Post partum
Acute gastroenteritis
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A patient with eosinophilic gastroenteritis of 30 years' duration is presented. During the course of the illness, anemia, hepatosplenomegaly, diarrhea and hepatic giant cell granulomas with surrounding eosinophilia were noted. The differential diagnosis of the granulomatous lesion is discussed. The patient's initially serious but subsequently benign illness illustrates the diverse manifestations of eosinophilic gastroenteritis. The need for a cautious therapeutic approach to the disorders of eosinophilia and organ infiltration is emphasized.
Eosinophilic gastroenteritis
Hepatosplenomegaly
Eosinophilic granuloma
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Eosinophilic esophagitis, gastroenteritis and colitis are very likely underdiagnosed conditions, and their actual incidence may be increasing. The diagnosis and treatment remain, however, fairly poorly established and are based on inadequate scientific evidence. Differential diagnosis is broad, mainly conditions causing secondary eosinophilia, such as allergies. If the secondary causes have been carefully excluded, the possibility of rare hypereosinophilic syndrome should be considered in prolonged eosinophilia.
Eosinophilic Esophagitis
Eosinophilic gastroenteritis
Hypereosinophilic Syndrome
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Over the last two decades, an increased recognition of gastrointestinal mucosal eosinophilia has heightened awareness and stimulated discussion regarding a number of often confusing but clinically relevant questions. What constitutes pathological mucosal eosinophilia? What are pathophysiological mechanisms leading to this response? What diseases are characterized by mucosal eosinophilia? What treatments resolve mucosal eosinophilia and its associated symptoms? This chapter will focus on describing the differences between and similarities shared by a narrow group of diseases referred to as eosinophilic gastrointestinal diseases or EGIDs. EGIDs are a group of gastrointestinal diseases characterized by a wide range of abdominal symptoms that occur in association with intestinal eosinophilia, when other causes of eosinophilia have been ruled out. Traditional descriptions of these diseases categorized them by histological groupings (mucosal, muscular, serosal) whereas more recent classifications have subdivided EGIDs by the primary organ affected (eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis and eosinophilic colitis).
Eosinophilic Esophagitis
Eosinophilic gastroenteritis
Gastrointestinal disease
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