Eosinophilic Gastroenteritis Masquerading as Ampullary Adenoma

Madhotra, Ravi; Eloubeidi, Mohamad A.; Cunningham, J. T.; Lewin, David; Hoffman, Brenda J.

doi:10.1097/00004836-200203000-00009

Cited by 22 publications

(6 citation statements)

References 7 publications

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“…Involvement of the serosal layer may cause peritoneal irritation, which can lead to ascites, peritonitis and perforation in more severe cases; intestinal intussusception may occur in the serosal type as well[17]. An additional manifestation of the disease, peripapillary duodenal disease, which is secondary to the eosinophilic infiltration of the peripapillary duodenal region, might result in pancreatitis and biliary obstruction[18,19]. …”

Section: Diagnosismentioning

confidence: 99%

Eosinophilic gastroenteritis: Approach to diagnosis and management

Rached

Hajj

2016

WJGPT

102

128

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Eosinophilic gastroenteritis (EGE) is a rare and benign inflammatory disorder that predominantly affects the stomach and the small intestine. The disease is divided into three subtypes (mucosal, muscular and serosal) according to klein’s classification, and its manifestations are protean, depending on the involved intestinal segments and layers. Hence, accurate diagnosis of EGE poses a significant challenge to clinicians, with evidence of the following three criteria required: Suspicious clinical symptoms, histologic evidence of eosinophilic infiltration in the bowel and exclusion of other pathologies with similar findings. In this review, we designed and applied an algorithm to clarify the steps to follow for diagnosis of EGE in clinical practice. The management of EGE represents another area of debate. Prednisone remains the mainstay of treatment; however the disease is recognized as a chronic disorder and one that most frequently follows a relapsing course that requires maintenance therapy. Since prolonged steroid treatment carries of risk of serious adverse effects, other options with better safety profiles have been proposed; these include budesonide, dietary restrictions and steroid-sparing agents, such as leukotriene inhibitors, azathioprine, anti-histamines and mast-cell stabilizers. Single cases or small case series have been reported in the literature for all of these options, and we provide in this review a summary of these various therapeutic modalities, placing them within the context of our novel algorithm for EGE management according to disease severity upon presentation.

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Section: Diagnosismentioning

confidence: 99%

Eosinophilic gastroenteritis: Approach to diagnosis and management

Rached

Hajj

2016

WJGPT

102

128

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“…EG may present as gross appearance of a malignant gastric ulcer, however presentation as gastric or duodenal ulcer is extremely rare. As EG lacks specific symptoms and may mimic malignancy (even surgery had been reported in EG patient for suspicion of malignancy),[ 2 3 4 ] it should be considered in the differential diagnosis of atypical cases as the present case which had a nonhealing gastric ulcer with the appearance of a malignant lesion, however, without constitutional symptoms of gastric malignancy. EUS in cases of EG may show thickening of mucosa and submucosa or normal wall layer pattern in cases of mucosal form of the disease.…”

Section: Discussionmentioning

confidence: 96%

“…EG can be divided into mucosal form (may present as pain, nausea, vomiting, diarrhea, fecal occult blood loss, anemia, or protein-losing enteropathy), muscular form (present as intestinal obstruction) and serosal form (present as ascites). [ 1 2 ] The presenting symptoms depend on the site and depth of intestinal involvement. In the present case, both CT and EUS suggested malignancy.…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic gastroenteritis mimicking as a malignant gastric ulcer with lymphadenopathy as shown by computed tomography and endoscopic ultrasound

et al. 2015

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“…Peripheral eosinophilia and elevated IgE are suggestive findings of initial laboratory testing. 3,15 Additional testing may include allergy evaluation by skin and serum radioallergosorbent tests, albumin and protein levels, ␣-1 antitrypsin levels, and analysis of ascitic fluid for eosinophils. 1 Radiologic tests are nonspecific but may show varying degrees of inflammation such as mucosal thickening and irregularity.…”

Section: Diagnostic Testingmentioning

confidence: 99%

Eosinophilic Gastroenteritis Presenting with Severe Anemia and Near Syncope

Ekunno

Munsayac

Pelletier

et al. 2012

The Journal of the American Board of Family Medicine

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Eosinophilic gastrointestinal disorders or eosinophilic digestive disorders encompass a spectrum of rare gastrointestinal disorders that includes eosinophilic esophagitis, eosinophilic gastroenteritis, and eosinophilic colitis. Eosinophilic gastroenteritis is a rare inflammatory disease characterized by eosinophilic infiltration of the gastrointestinal tract. The clinical manifestations include anemia, dyspepsia, and diarrhea. Endoscopy with biopsy showing histologic evidence of eosinophilic infiltration is considered definitive for diagnosis. Corticosteroid therapy, food allergen testing, elimination diets, and elemental diets are considered effective treatments for eosinophilic gastroenteritis. The treatment and prognosis of eosinophilic gastroenteritis is determined by the severity of the clinical manifestations. We describe a 24-year-old woman with eosinophilic gastroenteritis presenting as epigastric pain with a history of severe iron deficiency anemia, asthma, eczema, and allergic rhinitis, and we review the literature regarding presentation, diagnostic testing, pathophysiology, predisposing factors, and treatment recommendations. (J Am Board Fam Med 2012;25:913-918.) Keywords: Case Reports, Eosinophilic Gastroenteritis, Gastrointestinal DisordersA 24-year-old nulliparous African-American woman was admitted after an episode of near syncope associated with 2 days of fatigue and dizziness. She reported gradual onset of dyspepsia over 2 to 3 months. She denied nausea, vomiting, menorrhagia, polymenorrhea, diarrhea, hematemesis, melena, or hematochezia. Her medical history was significant for allergic rhinitis, eczema, and asthma. Her surgical history was negative. She denied using tobacco or illicit drugs. She drank approximately 1 to 2 beers per month. Her family history was significant for a father with asthma and hypertension and a mother with hypertension. Her medications included inhaled fluticasone, an albuterol metered-dose inhaler, a Flovent inhaler, loratadine, and ranitidine.During examination, her height was 62 inches, weight 117 lb, and body mass index 21.44 kg/m 2 . Her heart rate was 111 beats per minute, blood pressure 121/57 mm Hg, respiratory rate 20 breaths per minute, and oral temperature of 98.6°F. She appeared acutely ill and lethargic. She was oriented to person, place, and time. She had pallor of the conjunctiva. Cardiovascular, respiratory, musculoskeletal, and neurological examinations were normal. Her abdomen was soft and nontender, without organomegaly. Rectal examination revealed brown stool that was hemoccult negative.Initial laboratory tests revealed a hemoglobin level of 5.1 g/dL (normal range, 12.0-16.0 g/dL), a hematocrit level of 17.1% (normal, 37.0% to 47.0%), a mean corpuscular volume of 66.9 fL (normal, 80.0 -98.0 fL), a red blood cell distribution width of 31.1%F (normal, 11.5-18.0%F), and a platelet count of 921,000/mm 3 (normal, 150,000 -400,000/mm 3 ). The white blood cell differential included 82% neutrophils, 5% lymphocytes, 5% monocytes, 6% eosinophils, and 2% basop...

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Eosinophilic Gastroenteritis Masquerading as Ampullary Adenoma

Cited by 22 publications

References 7 publications

Eosinophilic gastroenteritis: Approach to diagnosis and management

Eosinophilic gastroenteritis: Approach to diagnosis and management

Eosinophilic gastroenteritis mimicking as a malignant gastric ulcer with lymphadenopathy as shown by computed tomography and endoscopic ultrasound

Eosinophilic Gastroenteritis Presenting with Severe Anemia and Near Syncope

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