| Objective: To determine the clinical features,laboratory tests,endoscopic manifestations,histopathological changes and treatment of children with eosinophilic gastroenteritis,so as to improve clinicians' understanding of this disease.Subjects and Methods: The clinical data of children with EG from January 2009 to January 2019 in Children's Hospital of Chongqing Medical University were retrospectively collected.Results:1.The general information: A total of 23 children with EG were collected,and there were more males than females,the ratio of males to females was 1.9:1.According to Klein's type,there were 18 cases(87.0%)of mucosa type,1 case(4.3%)of mixed type(also involving the muscle and mucosa),and 2 cases(8.7%)of mixed type(also involving the serosa and mucosa).2.Clinical manifestations: There were 14 cases of abdominal pain(60.9%),11 cases of vomiting(47.8%),6 cases of bloody stool(26.1%),4cases of diarrhea(17.4%),4 cases of edema(17.4%),2 cases of ascites(8.7%),and 1 case of hematemesis(4.3%).3.Laboratory examination: There were 11/23 cases of peripheral blood eosinophil count increased,12/23 cases of mild and moderate anemia,3/22 cases of increased CRP level,11/18 cases of positive occult blood test,5/7 cases of increased specific IgE level,and 2/4 cases of positive atopy patch testing.Bone marrow cytology showed increased EOS in 5/6 patients and iron deficiency anemia in 1/6 patient.Ascites tests were performed in 2patients,and large amounts of EOS(94-97%)were observed in ascites smears.4.Endoscopic examination: Endoscopic examination showed hyperemia(22 cases),edema(22 cases),erythema(20 cases),erosion(13cases),hyperplasia(7 cases),ulcer(5 cases),obstruction(2 cases),and gastrointestinal wall stiffness(2 cases).The lesions were mainly found in the gastric antrum,gastric body,and gastric fundus during gastroscopy.5.Histological examination: EOS infiltrated the gastric antrum in 8cases,duodenum in 11 cases,gastric body in 2 cases,esophagus in 1 case,colon in 5 cases,and rectum in 2 cases,with a density of 20-100/HP.6.Treatment: 7/23 cases were treated with steroids,8/23 cases were treated with monteluster sodium,4/23 cases were treated with both steroids and monteluster sodium,all of their clinical symptoms were significantly relieved,and a total of 2 cases relapsed.Conclusion: The majority of EG children in this group were male,with a variety of non-specific gastrointestinal symptoms.Most of the children with mucosal type had abdominal pain as the first symptom,those with muscle type had vomiting as the first symptom,and those with serosa type had ascites as the first symptom.In the process of diagnosis,it is necessary to comprehensively trace the changes of clinical symptoms and signs of children in order to facilitate the early detection and diagnosis of EG.The clinical manifestations are closely related to the depth of eosinophilic infiltration.Eosinophilic gastroenteritis should be highly suspected in patients with gastrointestinal symptoms accompanied by increased eosinophils in peripheral blood and bone marrow cytology.Large amount of eosinophils infiltration gastrointestinal is the key to diagnosis,and multiple biopsies is recommended to avoid missed diagnosis.Steroids,montelukast sodium,or a combination of the two are effective in treatment.However,the children with EG can relapse,and steroids and immunosuppressant are still effective for children with recurrence. |
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