Clinical Analysis Of 88 Patients With Eosinophilic Gastroenteritis

Objective1.Analyze the general data,clinical characteristics,treatment and prognosis of the patients diagnosed with eosinophilic gastroenteritis in our hospital in recent 5 years;2.Combining with the latest research results in recent years and the consensus of new guidelines,this paper discusses the diagnosis points and treatment methods of eosinophilic gastroenteritis,in order to provide a new scheme for clinical treatment,and to provide new ideas for further research.Methods1.Screening of patients with eosinophilic gastroenteritis in our hospital for nearly5 years with the criteria used in this study;2.Study on the clinical data of selected patients by retrospective analysis.ResultsThis study included a total of 88 patients who met the diagnostic criteria,of whom48 were men and 40 were women,male:female=1.2:1,median age 44.5 years(14-73years),45 were at the age of 30-50,accounting for 51.1%.23 people have a long drinking history,accounting for 26.1%.15 people have a clear history of allergies,accounting for 17%.3 patients were diagnosed with other allergic diseases diagnosed by the relevant departments:one had asthma,two had urticaria.All the patients included in the study ruled out parasitic infection and malignant tumor of the digestive system.78 patients with abdominal pain symptoms,accounting for 88.6%,other common symptoms are abdominal distension(37.5%),nausea(29.5%),diarrhea(28.4%),vomiting(21.6%),acid regurgitation(15.9%),upper abdominal burning discomfort(14.8%),etc.Other accompanying symptoms are anorexia,emaciation,belching and so on.In laboratory examination,peripheral blood routine shows 70patients having an increasing eosinophilic granulocyte count,accounting for 79.5%,the average is 4.72x10~9/L,and the maximum is 29.66x10~9/L.51 patients recieved immunoglobulin examination,11 had elevated IgE level,accounting for 21.6%,median is 704.9 IU/ml,and the maximum value reaches 2500 IU/ml(the upper limit of our hospital examination).66 patients received serum allergen mornitor,44 found positive allergens,accounting for 73.3%.Bone marrow puncture was done in 40 patients,and bone marrow fluid smear shows 37 patients having increasing in the proportion of eosinophilic granulocytes,accounting for 92.5%,median value is 16%,maximum is72.4%.Of the 62 patients with abdominal CT examination,the digestive tract was completely normal in 13 people,the abdominal lymph nodes enlarged in 16 people,the digestive tract wall thickened in 16 people,and 13 people had the peritoneal effusion,other abnormalities were intestinal stenosis,effusion,dilation and so on.Gastroscopy82 cases,of which roughly normal patients are 21 cases,accounted for 25.6%,most commom abnormality is hyperemia,followed by erosion,ulcer,edema,uplift/polyps and so on.Colonoscopy 70 cases,of which roughly normal total are 43 cases,accounted for 61.4%,the most common abnormality is uplift/polyps,followed by erosion,congestion and so on.Pathological examination showed a high average of eosinophilic infiltration in duodenum under gastroscopy and in the end of the ileum and the ileocecal junction under colonoscopy.In terms of treatment,a total of 11 people was treated with food elimination diet,5 of whom had symptom improvement and the effective rate is45.5%.25 patients only with the upper gastrointestinal tract influenced were treated with PPI,of whom 15 were effective.65 patients eventually received glucocorticoid treatment,all had good drug response,one patient showed severe infection combined with septic shock after 10-months glucocorticoid therapy and eventually died.We don’t receive other death reports from others.Conclusions1.Patients with abdominal symptoms,especially abdominal pain,bloating,diarrhea,nausea,vomiting,pretending there is an increase in eosinophilic granulocyte counts in peripheral blood,and abdominal CT,endoscopic examination performance is not specific,after excluding other diseases with elevated eosinophilic cells,we should consider the possibility of eosinophilic gastroenteritis,and do allergen detection,bone marrow smear examination and biopsy histopathological examination.2.Male patients were younger around 41 years old,while female patients around50.5 years old.3.Serum IgE level was not related to the level of eosinophilic granulocytes in peripheral blood.It is suggested that IgE does not promote the main factors of eosinophilic increase during the occurrence of the disease.4.At present,the diagnosis of eosinophilic gastroenteritis cannot be separated from pathological examination.Wide biopsy under endoscopy can improve the positive rate.The positive rate of biopsy is higher in the duodenum,the end of the ileum and ileocecal junction.5.Food elimination diet and PPI are effective in some patients.Glucocorticoid therapy can achieve good therapeutic results,but there are many complications and cannot be used for long-term maintenance treatment.The disease can be induced again after contact with allergens again,but glucocorticoid therapy is still effective.