Journal List > Korean J Gastroenterol > v.55(6) > 1006674

Jeon, Lee, Jung, Kim, Ji, Kim, and Choi: Clinical Characteristics of 17 Cases of Eosinophilic Gastroenteritis

Abstract

Background/Aims

Eosinophilic gastroenteritis (EG) is a rare disease characterized by prominent eosinophilic infiltration that may involve a variable depth of one or more gastrointestinal organs. We analyzed the largest number of patients with EG among the studies carried out at a single center in Korea.

Methods

We retrospectively analyzed the clinical, laboratory, endoscopic, and radiologic features, management, and clinical outcome in 17 patients who were diagnosed as EG from January 1994 to Febuary 2008.

Results

Median age was 36 (2-67 years). Two of the 17 patients had a history of allergy. The most common symptoms were abdominal pain and diarrhea. Fifteen patients (88.2%) had hypereosinophilia. The ESR was moderately raised in 6 out of 14 patients. Eleven patients (64.7%) had predominant involvement of the mucosa, 1 (5.9%) of muscularis, and 5 (29.4%) of subserosa. EGD revealed non-specific findings such as erythema and edema. Abdominal Computed tomography revealed gastrointestinal wall thickenings of the involved organ, and all of 5 cases of the subserosal type had ascites. Thirteen patients (76.5%) were improved by corticosteroid treatment. Among five patients who had been followed for more than one year (12-84 months), two experienced relapse after discontinuing corticosteroids.

Conclusions

EG should be considered in the differential diagnosis of unexplained gastrointestinal symptoms even in the absence of peripheral eosinophilia and in non-specific endoscopic findings.

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Table 1.
Demographic Characteristics and Laboratory Findings according to the Klein's Classification
Group Patient No. Age Sex WBC (/mm3) Eosinophil (/mm3) Albumin (g/dL) Ig E (IU/mL)
Mucosal type 1 61 F 12,600 5,580 3.0 72
2 63 F 6,000 120 3.9
3 27 F 7,900 1,809 3.9 408
4 31 F 6,800 523 3.9 349
5 51 M 15,300 7,623 4.2 6,960
6 57 F 11,500 3,795 3.8
7 67 M 22,500 7,100 4.0 7,719
8 45 M 10,180 10,220 4.2 663
9 65 M 5,800 600 3.2 120
10 11 M 11,400 6,800 4.5 118
11 2 M 10,500 3,360 2.7 220
Muscular type Serosal type 12 45 F 5,900 170 3.2 1,135
13 34 F 10,600 5,800 3.7 41
14 36 F 12,300 4,674 3.5 56
15 32 M 14,920 8,140 4.0
16 18 M 10,100 6,440 4.4 510
17 24 F 10,420 2,199 3.2 384
Table 2.
Presenting Symptoms of the 17 Patients
Symptom Involved layer
Mucosal (n=11) Muscular (n=1) Serosal (n=5) Total (n=17)
Abdominal pain 8 1 4 13
Diarrhea 7 0 2 9
Nausea/vomiting 4 1 2 7
Weight loss 2 1 0 3
Bloating 0 0 2 2
Bloody stool 2 0 0 2
Poor appetite 0 0 2 2
Edema 1 0 0 1
Table 3.
Summary of the Clinical Features and Outcome
Patient no. Location Confirmation method Treatment Outcome (duration of follow-up)
1 SB Endoscopy H2 RA Resolved (5 months)
2 Stomach Endoscopy H2 RA No follow-up
3 SB Endoscopy Steroid No follow-up
4 Stomach, SB Endoscopy Steroid, Azathioprine Symptom continued (84 months)
5 Colon Endoscopy Steroid Resolved (1 month)
6 Colon Endoscopy Steroid Resolved (3 months)
7 Colon Endoscopy Steroid No follow-up
8 Stomach, SB Endoscopy Steroid Relapse (37 months)
9 SB Endoscopy Steroid Resolved (1 month)
10 Colon Endoscopy Steroid Resolved (1 month)
11 Stomach, SB, Colon Endoscopy Steroid Resolved (2 months)
12 Stomach Surgery Surgery, Steroid Symptom continued (73 months)
13 Esophagus, Stomach, SB, Endoscopy, Paracentesis Steroid Resolved (12 months)
Colon, Rectum
14 Stomach, SB Endoscopy, Paracentesis Steroid No follow-up
15 Stomach, SB, Colon Paracentesis Steroid Resolved (4 months)
16 Stomach, SB, Colon Paracentesis Steroid Resolved (3 months)
17 Esophagus, Stomach, SB Paracentesis Steroid Relapse (24 months)

H2 RA, H2 receptor antagonist; mon, month; SB, small bowel.

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