Carbamazepine‐Induced Eosinophilic Colitis

Anttila, Veli‐Jukka; Valtonen, Matti

doi:10.1111/j.1528-1157.1992.tb02293.x

Cited by 87 publications

(21 citation statements)

References 8 publications

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“…Drug or toxin exposure is the cause of a few cases of eosinophilic gastroenteritis [53][54][55][56][57][58][59]. Recently, a case of enalapril-induced eosinophilic gastroenteritis was reported in a 63-year-old woman from Chicago [57]; in another case, gemfibrozil was associated [58].…”

Section: Drugsmentioning

confidence: 98%

Eosinophilic gastroenteritis

Daneshjoo

Talley

2002

Curr Gastroenterol Rep

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Eosinophilic gastroenteritis is a rare gastrointestinal (GI) disorder of undetermined cause characterized by infiltration of eosinophils in the GI tract. Eosinophils accumulate in tissues and may release highly cytotoxic granular proteins, which cause severe tissue damage characteristic of eosinophilic gastroenteritis. Eotaxin may play a role in the recruitment of eosinophils into tissue in combination with chemoattractants and cytokines, including interleukin 3 and 5 and granulocyte-macrophage colony-stimulating factor. Food allergy, especially in children, can be a triggering factor, and an amino acid-based diet may be helpful. Accumulation of eosinophils in the gut is a common feature in food-induced GI disorders that can be regulated through a complex molecular network involving Th2 cells, various cytokines, and chemokines. Eosinophilic gastroenteritis has a wide spectrum of clinical presentation depending on the site of involvement. It may be confused with irritable bowel syndrome or dyspepsia and, rarely, mimics pancreatitis or appendicitis. Diagnosis is important and is usually made by a pathologist. Eosinophilic gastroenteritis is a treatable disease; patients generally respond to steroid therapy, although relapse is common. Non-enteric-coated budesonide, a locally acting corticosteroid with little risk of adrenal suppression, may be substituted, although more experience is needed. Promising new drugs for eosinophilic gastroenteritis include montelukast, a selective leukotriene receptor antagonist, and suplaplast tosilate, a selective Th2 cytokine inhibitor with inhibitory effects on allergy-induced eosinophilic infiltration and IgE production. Although it is likely a separate disease, more experience has accumulated, and an elimination or specific amino acid-based diet appears to be helpful in treatment.

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Section: Drugsmentioning

confidence: 98%

Eosinophilic gastroenteritis

Daneshjoo

Talley

2002

Curr Gastroenterol Rep

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“…In the differential diagnosis specific for EC -Drug-induced EC has been described from various medications including clozapine [158], carbamazepine [159], rifampicin [160], non-steroidal anti-inflammatory drugs [161], tacrolimus [162], and gold [163]. -EC can also be a sign of early inflammatory bowel disease (IBD), in particular Crohn's disease [164], or autoimmune especially connective tissue diseases (scleroderma, lupus polymyositis, and dermatomyositis) [165,166].…”

Section: Diagnosismentioning

confidence: 99%

Eosinophilic Esophagitis and Gastroenteritis

Cianferoni

Spergel

2015

Curr Allergy Asthma Rep

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Eosinophilic gastrointestinal disease (EGID) can be classified as eosinophilic esophagitis (EoE) when the eosinophilia is limited to the esophagus or as eosinophilic gastritis (EG) if it is limited to the gastric tract, eosinophilic colitis (EC) if it is limited to the colon, and eosinophilic gastroenteritis (EGE) if the eosinophilia involves one or more parts of the gastrointestinal tract. EoE is by far the most common EGID. It is a well-defined chronic atopic disease due to a T helper type 2 (Th2) inflammation triggered often by food allergens. EoE diagnosis is done if an esophageal biopsy shows at least 15 eosinophils per high power field (eos/hpf). Globally accepted long-term therapies for EoE are the use of swallowed inhaled steroids or food antigen avoidance. The treatment of EoE is done not only to control symptoms but also to prevent complications such as esophageal stricture and food impaction. EGE cause non-specific gastrointestinal (GI) symptoms and are diagnosed if esophagogastroduodenoscopy (EGD)/colonoscopy show eosinophilia in one or more parts of the GI tract. They are rare diseases with an unclear pathogenesis, and they are poorly defined in terms of diagnostic criteria and treatment. Before initiating treatment of any EGE, it is imperative to conduct a differential diagnosis to exclude other causes of hypereosinophilia with GI localization. EGE are often poorly responsive to therapy and there is no commonly accepted long-term treatment. EG has many characteristics similar to EoE, including the fact that it is often due to a food allergen-driven Th2 inflammation; transcriptome analysis however shows that it is more a systemic disease and has a different gene signature than EoE. EC is a benign form of delayed food allergy in infant and is instead a difficult-to-treat severe inflammatory condition in older children and adults. EC in the latter groups can be a manifestation of drug allergy or autoimmune disease. Overall EGE, EC, and EG are rare and are a diagnosis of exclusion until more common causes of eosinophilia have been excluded.

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“…Drugs, especially aspirin, prostaglandin,8 and other non-steroidal anti-inflammatory drugs, are among the most important causes of peptic strictures causing stenosis. Likewise sulfonamides, penicillin, cephalosporins, carbamazapine, and azathioprine9 are also reported as a cause GI eosinophilia. L-tryptophan and gold salts have also been implicated in causing EG, but our patient denied use of any such medications.…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic gastroenteritis causing stenosis of bulbo-duodenal junction: medical and endoscopic management

Ashraf

Ashraf²,

Al-Karawi³

et al. 2009

Case Reports

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Eosinophilic gastroenteritis is a rare disease characterised by tissue eosinophilia that can involve any layer or part of the gut from the oesophagus to the rectum. In Saudi Arabia, the disease has not been reported in the literature before. We report the disease entity as an unusual cause of gastric outlet obstruction. A 50-year-old man was admitted through the gastrointestinal clinic with complaints of epigastric pain associated with dyspepsia for 1 month, and weight loss of 4 kg in 2 months. Examination revealed only the epigastric tenderness on deep palpation. Laboratory investigations including full blood count, liver function tests and renal function tests were normal. Gastroscopy disclosed stenosis of the second and third part of the duodenum. Biopsies were taken and the patient underwent endoscopic dilatation of the pylorus and duodenal bulb. Histopathology showed chronic active eosinophilic inflammation. The patient was successfully treated with a tapering course of steroids and had a complete recovery post-endoscopic dilatation.

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Carbamazepine‐Induced Eosinophilic Colitis

Cited by 87 publications

References 8 publications

Eosinophilic gastroenteritis

Eosinophilic gastroenteritis

Eosinophilic Esophagitis and Gastroenteritis

Eosinophilic gastroenteritis causing stenosis of bulbo-duodenal junction: medical and endoscopic management

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