Eosinophilic Gastroenteritis Presentation Of 5 Patients With Literature Review

Aim To investigate the clinical diversities of eosinophilic gastroenteritis. Laboratory tests, endoscopy, treatments including food, drugs and operations, causes of misdiagnosis are all discussed in the article.Method There are mainly two diagnostic standards: Talley standard and Leinbach standard. Talley standard: ①gastrointestinal symptoms; ②one or more leisions of gastrointestinal duct involved with eosinophilic cells, or abnormal barium meal, abnormal endoscopy with increased eosinophilic cells; ③excluding parasite infection and other diseases with increased eosinophilic cells, not involving in gastrointestinal duct. Leinbach standard : ①increased eosinophilic granulocyte in peripheral blood; ②gastrointestinal symptoms appear after meals; ③histology proves that eosinophilic cells involve in gastrointestinal duct. Five cases were selected in our hospital from January, 2000 to May, 2006 according to Talley standard.Retrospectively, those cases diagnosed eosinophilic gastroenteritis were analyzed. We discussed predisposing factors, hypersusceptibilities, clinical features, laboratory tests, imaging examinations and endoscopy by literature reviews. Results ①there were 3 in 5 patients having predisposing factors. One patient was sensitive to "salad oil", one was sensitive to mutton, and another was sensitive to Chinese herbal medicine. Three patients had hypersusceptibilities. Two were sensitive to penicillin, and another was sensitive to sulfamido; ②The clinical features include abdominal pain, diarrhea, abdominal distention, nausea, vomiting, ascites, gastrointestinal blooding and so on. The analysis of clinical features as follows: abdominal pain(100%) , accompanied by diarrhea(60%) , abdominal distention, nausea, vomiting, ascites, gastrointestinal blooding and so on; ③laboratory tests: WBC 4.0-17.4 ×10~9/L, with average 11.9×10~9/L, and percent of eosinophilic cells 7.3%-49.2%, with average 28.78%; one patient's bone marrow routine test showed increased percentage of eosinophilic cells; abnormal results of Hepatic Lipase, Albumin(ALB), erythrocyte sedimentation rate (ESR), immunoglobins; ④ histopathology of endoscopy biopsy showed eosinophilic cells infiltrating ; the bone marrow biopsy showed hematopoeisis hyperplasia with increased eosinophilic cells;⑤threecases were misdiagnosed at first. One was misdiagnosed tuberculous peritonitis, and other two cases were misdiagnosed intestinal obstruction. At last , we made correct diagnosis by Talley Standard; ⑥there are seven causes of misdisgnosis: (1) being lack of deep study on eosinophilic gastroenteritis; (2)the diversity of clinical features with no specificity; (3) there was no specificities by endoscopy with limited biopsy range and depth; (4) laparoscope examination couldn't be used in a normal way; (5) ascites test is very important; (6) pay no attention to increased eosinophilic cells or there is no increase at first; (7) mistakes made by a technician or a analysis machine; (7) the patients suffered no symptoms anymore, and their peripheral blood routine tests became normal after treatment. (WBC 4.8-13.9×109/L, average 8.4×109/L, and percent of eosinophilic cells 2.3%-5.1%, with average 3.68%). The results were statistically significant (P<0.05).Conclusion The clinical features of eosinophilic gastroenteritis is diversiform. The histopathology examination of eosinophilic gastroenteritis is the diagnostic key point. Hormones is effective to treat this disease.