Acute Eosinophilic Ascites in a Middle-Aged Man

Abstract

Eosinophilic gastroenteritis is a rare condition characterized by recurrent eosinophilic infiltration of portions of the GI tract and presenting with nonspecific GI symptoms in association with peripheral eosinophilia. Its etiology and pathogenesis remain unclear and its symptoms overlap with many GI and systemic diseases. Thus, both gastroenterologists and general internists need to be aware of this rare condition. We present a case of a 55-year-old male with diffuse abdominal pain and distention for two weeks. His physical examination was significant for moderate ascites. Initial work-up demonstrated severe peripheral blood eosinophilia, normal liver function tests, thickening of the stomach and small bowel wall, and elevated serum IgE. Upper endoscopy and extensive testing for malignancy and parasitic infections failed to establish a diagnosis. Ascitic fluid analysis showed significant eosinophilia. Further, a full-thickness jejunal showed marked eosinophilic infiltration of the serosa and muscularis propria. Subsequent treatment with oral prednisone resulted in normalization of laboratory and radiologic abnormalities in a few week period.

Eosinophilic Ascites: Singular Presentation of Eosinophilic Gastrointestinal Disorder

“…We report the case of a young adult atopic patient in whom clinical presentation and histopathological findings confirmed EGE and EA, as previously described [5]. In 1970, Klein et al [6] divided the most common EGE classification into 3 different patterns, namely, the mucosal, muscular, and serosal patterns.…”

Eosinophilic ascites with marked peripheral eosinophilia

“…EGE can occur in adult and paediatric populations [3][4][5][6][7][8][9][10] and although the condition is generally more common in men [11], the serosal form with ascites more commonly affects women [12]. EGE can occur in adult and paediatric populations [3][4][5][6][7][8][9][10] and although the condition is generally more common in men [11], the serosal form with ascites more commonly affects women [12].…”

Eosinophilic Gastroenteritis with Appendix Involvement: Role of Intestinal Ultrasound

“…Usually biopsies are recommended in all the mucosal lesions identified and in all the GI tract examined, because of the patchy involvement of the disease [10]. Biopsies of the bowel wall by means of laparotomy [22] can be performed in case of presentation of serosal patterns, and for diagnostic paracentesis [23,24].…”