Journal List > Korean J Pediatr Gastroenterol Nutr > v.14(2) > 1043505

Korean J Pediatr Gastroenterol Nutr. 2011 Jun;14(2):181-186. Korean.
Published online June 30, 2011.
Copyright © 2011 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
A Case of Non-IgE-mediated Eosinophilic Gastroenteritis Presenting as Ascites
Eun Sang Yi, M.D., Mi Jin Kim, M.D., Sang Yun Ha, M.D.,* Yoo Min Lee, M.D., Kyong Eun Choi, M.D. and Yon Ho Choe, M.D.
Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.
*Department of Pathology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.

Corresponding author (Email: )
Received April 18, 2011; Revised June 05, 2011; Accepted June 08, 2011.


Eosinophilic gastroenteritis is a rare disease occurring especially in children, and shows various non-specific presentations with infiltration of eosinophils in the gastrointestinal organs. The pathophysiology of eosinophilic gastroenteritis is not yet clearly known, but allergic reactions are suspected to be related with the disease. Eosinophilic gastroenteritis is categorized into the mucosal, muscularis and subserosal types based on which layer of the intestinal wall is involved. There are different clinical manifestations according to the involved layer. Most cases to date have responded well to steroid therapy. In this study, we diagnosed and treated a case of non-IgE-mediated, subserosal eosinophilic gastroenteritis in a child with abdominal pain, diarrhea and ascites.

Keywords: Non-IgE-mediated; Eosinophilic gastroenteritis; Ascites


Fig. 1
The ascitic fluid shows many eosinophils.
Click for larger image

Fig. 2
Abdomen CT showed diffuse wall thickening of the small and large bowel.
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Fig. 3
The endoscopic biopsy findings showed a marked eosinophil infiltration in the second portion of the duodenum (A) and the rectum (B) (H&E stain, 400).
Click for larger image

1. Kim AS, Kim HJ, Choi YH. A case of eosinophilic ascites noted in eosinophilic gastroenteritis. Korean J Clin Pathol 1999;19:271–274.
2. Jeon EJ, Lee KM, Jung DY, Kim TH, Ji JS, Kim HK, et al. Clinical characteristics of 17 cases of eosinophilic gastroenteritis. Korean J Gastroenterol 2010;55:361–367.
3. Kaijser R. Zur kenntnis der allergischen affectionen des verdauungskanals vom standpunkt des chirugen aus. Arch Klin Chir 1937;188:36–64.
4. Talley NJ, Shorter RG, Phillips SF, Zinsmeister AR. Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues. Gut 1990;31:54–58.
5. Kim NI, Jo YJ, Song MH, Kim SH, Kim TH, Park YS, et al. Clinical features of eosinophilic gastroenteritis. Korean J Gastroenterol 2004;44:217–223.
6. Katz AJ, Twarog FJ, Zeiger RS, Falchuk ZM. Milk-sensitive and eosinophilic gastroenteropathy: similar clinical features with contrasting mechanisms and clinical course. J Allergy Clin Immunol 1984;74:72–78.
7. Park HS, Kim HS, Jang HJ. Eosinophilic gastroenteritis associated with food allergy and bronchial asthma. J Korean Med Sci 1995;10:216–219.
8. Orenstein SR, Shalaby TM, Di Lorenzo C, Putnam PE, Sigurdsson L, Mousa H, et al. The spectrum of pediatric eosinophilic esophagitis beyond infancy: a clinical series of 30 children. Am J Gastroenterol 2000;95:1422–1430.
9. Guajardo JR, Plotnick LM, Fende JM, Collins MH, Putnam PE, Rothenberg ME. Eosinophil-associated gastrointestinal disorders: a world-wide-web based registry. J Pediatr 2002;141:576–581.
10. Shifflet A, Forouhar F, Wu GY. Eosinophilic digestive diseases: eosinophilic esophagitis, gastroenteritis, and colitis. J Formos Med Assoc 2009;108:834–843.
11. Klein NC, Hargrove RL, Sleisenger MH, Jeffries GH. Eosinophilic gastroenteritis. Medicine (Baltimore) 1970;49:299–319.
12. Kalantar SJ, Marks R, Lambert JR, Badov D, Talley NJ. Dyspepsia due to eosinophilic gastroenteritis. Dig Dis Sci 1997;42:2327–2332.
13. Khan S. Eosinophilic gastroenteritis. Best Pract Res Clin Gastroenterol 2005;19:177–198.
14. Daneshjoo R, N JT. Eosinophilic gastroenteritis. Curr Gastroenterol Rep 2002;4:366–372.
15. Steffen RM, Wyllie R, Petras RE, Caulfield ME, Michener WM, Firor HV, et al. The spectrum of eosinophilic gastroenteritis. Report of six pediatric cases and review of the literature. Clin Pediatr (Phila) 1991;30:404–411.
16. Zora JA, O'Connell EJ, Sachs MI, Hoffman AD. Eosinophilic gastroenteritis: a case report and review of the literature. Ann Allergy 1984;53:45–47.
17. Fenoglio LM, Benedetti V, Rossi C, Anania A, Wulhfard K, Trapani M, et al. Eosinophilic gastroenteritis with ascites: a case report and review of the literature. Dig Dis Sci 2003;48:1013–1020.
18. Furuta GT, Liacouras CA, Collins MH, Gupta SK, Justinich C, Putnam PE, et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology 2007;133:1342–1363.
19. DeBrosse CW, Case JW, Putnam PE, Collins MH, Rothenberg ME. Quantity and distribution of eosinophils in the gastrointestinal tract of children. Pediatr Dev Pathol 2006;9:210–218.
20. Um HJ, Kim BI, Park HD, Koo ES, Cho YK, Kim CS, et al. A case of eosinophilic gastroenteritis with diffuse small bowel edema and ascites. Korean J Med 2000;59:74–79.