Eosinophilic Gastroenteritis: Clinical Experience With 14 Patients

Aim:To analyze the clinic features of eosinophilic gastroenteritis and examine the diagnosis,treatment,long-term outcome of this disease.Methods:We retrospectively analyze the history of disease,the clinical manifestations, laboratory,endoscopic,pathologica findings,treatment,and clinical outcome in 14 patients who were diagnosed as eosinophilic gastroenteritis from 2000 to 2010 at The First Affiliated Hospital of ZhengZhou University.Results:Ten patients had predominant involvement 10 of mucosa,l of muscularis,and 3 of subserosa.All patients had different levels gastrointestinal symptoms,the most common symptoms were abdominal pain and diarrhea.Four of the 14 patients have a history of allergy.Ten patients have peripheral blood eosinophilia,fortheen patients have confirmed eosinophilic infiltration of the gastrointestinal tissues by endoscopic or surgical biopsy,3 patients in which have the presence of eosinophilic ascites.9 patient were treated with oral prednisolone,15 to 50 mg/day initially,the symptoms subsided within 1-2 weeks,and the eosinophil count decreased to normal level.All of the patients were followed up for more than 12 months (12 to 24 months),1 patients had predominant involvement of mucosa of these patients required long-term maintenance oral prednisolone to control symptoms, lOmg/day.l patients had predominant involvement of mucosa of whom had relapse of abdominal pain after discontinuing steroids(only 1 episode),were not treat by steroids,and the symptoms have disappeared.The remaining patients had not relapse after discharge,the prognosis is well.Conclusion:Eosinophilic gastroenteritis is a rare disease of unclear etiology and pathogensis characterized by pathy or diffuse eosinophilic infilltration of the gastrointestinal wall with various gastrointestinal manifestations.The history of allergy,eosinophilia in peripheral blood and(or) ascites and(or) bone marrow,radiological findings can help to established the diagnosis,but not a reliable diagnostic criterion.Definitive diagnosis requires histological evidence of eosinophilic infiltration by endoscopic biopsy or operative.However,eosinophilic gastroenteritis should be suspected in the presence of unexplained chronic or relapsing gastrointestinal symptoms even in the absence of peripheral blood eosinophilia.Steroids remain the mainstay of therapy for eosinophilic gastroenteritis,and the prognosis is well.