A Clinical Study Of Eosinophilic Gastroenteritis In 60 Cases

Research BackgroundEosinophilic gastroenteritis is an uncommon disease that characterized by eosinophil infiltration of the gastrointestinal tract,and may or may not be accompanied by peripheral blood eosinophilia.Because of its Clinical symptoms are usually non-specific,the initial misdiagnosed rate is high,and the number of cases reported in the past was low.In recent years,the incidence has an upward trend.ObjectiveTo retrospectively analyze the clinical characteristics,endoscopic features,diagnostic and treatment of eosinophilic gastroenteritis in order to improve the understanding of the disease,provide clues for early diagnosis and treatment as well as reduce misdiagnosis.MethodsRetrospectively analyze the allergic history of patients,clinical manifestations,laboratory examination,auxiliary examination,endoscopic and pathological examination,radiological examination,therapy and prognosis in 60 patients who were diagnosed as eosinophi lic gastroenteritis from 2012 to may 2016 at The First Affiliated Hospital of Zhengzhou University.Diagnostic criteria using Tally standard,classification criteria using Klein classification,the pathology standard using the 14 th edition of Practical Internal Medicine,the data analysis by SPSS17.0 statistical.Results1?60 cases with Eosinophilic Gastroenteritis were included in the research of which 33 were males and 27 were females.The onset age were 6 to 66 years old and the average ages of 60 patients were 37.47±14.50 years old.60 patients were divided into three groups including 51 of mucosa group,and 7 of Serous group,2 of muscularis group.2?Misdiagnosis rate:The initial misdiagnosed rate Was 68.3%,one weeks misdiagnosis rate was 30.1% in this group.3?Allergic history:31 patients have a history of allergy such as food or drug allergy.11 patients have the food triggers,such as Seafood,eggs,hot pot and so on.Twenty-five patients were allergic to allergens;25 cases(89.3%)were allergic to eggs,milk and other foods;20 patients received total Ig E examination,10 cases(50.0%)were elevated.4?Clinical characteristics: abdominal pain is primary clinical manifestation,The most common is paroxysmal colic.Other symptoms include diarrhea,bloating,nausea and vomiting,ascites,blood in the stool,fever,and rash.There were no significant differences in gastrointestinal symptoms between the three type of EG.5 ? Laboratory examination: Peripheral blood leukocyte of 60 patients Was(11.89±8.07)×10~9/L,the eosinophils was(4.61±6.43)×10~9/L.Among 60 patients,50 cases with eosinophilia,accounted for 83.3%.The difference of eosinophils counts before and after the one week's treatment in steroid therapy group was statistically(P <0.05).Three types of EG had different eosinophils counts,Serous type of EG had a higher eosinophilia counts(P<0.05).6 ? Auxiliary examination : 7 serous type of EG underwent ascites examination,ascites smear showed a large number of eosinophils;32 cases of EG underwent bone marrow smear examination,which increased eosinophils in 24 cases(75.0%).7?Endoscopic and pathological examination: 57 cases underwent gastroscopy and 41 cases underwent enteroscheocele with a lot of eosinophil infiltrated.The endoscopic appearance is nonspecific and involved in different parts.Pathology positive in 56 cases including 20 cases of sinuses ventriculi(accounted for 83.3%)and 26 of duodenum;(accounted for 83.3%).8?Radiological examination: 60 cases all performing abdominal computer tomography or ultrasound,Manifested as thickening of gastric wall or intestinal wall,ascites,abdominal lymph node enlargement,etc.which provide a cue to the diagnosis of EG.9?Therapy: Elemental diet therapy,anti-allergy treatment,hormone therapy can get a good effect.Eosinophil counts decreased significantly in the Patients with hormone therapy.10?Prognosis:Followed up for 3-53 mo,ten patients with EG recurrence,steroid Was still effective.Conclusin1?For mucosa and muscularis group of EG,endoscopic multiplesites biopsy is helpful to improve thediagnosticrate.A large number of eosinophile granulocyte in the gastrointestinal mucosa are key to the diagnosis.2?For Serous group of EG,A large number of eosinophile granulocyte in ascites are key to the diagnosis.3?Peripheral eosinophilic cells in Serous type of EG increased significantly more than other types.4?Hormone therapy can effectively relieve symptoms and reduce the eosinophil count of peripheral blood.