Eosinophilic gastroenteritis: Pathogenesis, diagnosis, and treatment

Li, Kaiwen; Ruan, Gechong; Liu, Shuang; Xu, Tianming; Guan, Kai; Li, Ji; Li, Jingnan

doi:10.1097/cm9.0000000000002511

Cited by 10 publications

(2 citation statements)

References 79 publications

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“…A comprehensive differential diagnosis is crucial when managing patients with recurrent intestinal obstruction. Conditions such as Crohn's disease, gastrointestinal malignancies, and other gastrointestinal disorders may present with similar symptoms, necessitating careful evaluation and consideration of all relevant clinical information [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic Enteritis Causing Recurrent Small Bowel Obstruction: A Case Report

Atuiri,

Zhang,

Cronin

2024

Cureus

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Eosinophilic enteritis is an inflammatory condition characterized by eosinophilic infiltration of the gastrointestinal tract. This case report highlights a unique presentation of eosinophilic enteritis as a cause of recurrent small bowel obstruction. The diagnosis was elusive despite extensive abdominal imaging. A histopathologic examination of a full-thickness bowel segment showing extensive eosinophilic infiltration in the muscularis propria was vital in establishing the diagnosis. This report underscores the diagnostic complexities associated with eosinophilic enteritis and the need to consider this condition as a potential cause of recurrent abdominal pain and small bowel obstruction.

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Section: Discussionmentioning

confidence: 99%

Eosinophilic Enteritis Causing Recurrent Small Bowel Obstruction: A Case Report

Atuiri,

Zhang,

Cronin

2024

Cureus

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“…For these reasons, our patient was treated with infliximab but did not show clinical remission. Abnormally increased eosinophil infiltration in the stomach and bowel is a key histopathological characteristic of non-EoE EGIDs [ 21 ]. Omalizumab, a humanized monoclonal antibody targeting the high-affinity IgE receptor, can reduce eosinophilia in the peripheral blood, bronchus, skin, and gut.…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic gastritis and gluten-sensitive enteropathy manifested as hypoproteinemia and treated with omalizumab: a case report

Du,

Wang,

Zhou

et al. 2024

Allergy Asthma Clin Immunol

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Background Eosinophilic gastritis (EoG) has rarely been reported in conjunction with gluten-sensitive enteropathy (GSE). When this does occur, patients typically present with gastrointestinal symptoms. To our knowledge, hypoproteinemia has not been reported as the primary manifestation. Anti-IgE therapy, such as omalizumab, lowers eosinophil counts in the blood, lungs, and gut. Its efficiency in treating active EoG remain unknown. Case presentation We report a 33-month-old boy with a history of food allergy and atopic dermatitis who developed recurrent edema, hypoproteinemia, and eosinophilia at the age of 14 months. The diagnoses of EoG and GSE were confirmed based on the clinical presentation and results of gastrointestinal biopsies and serological testing. Although prednisone and dietary intervention were initially effective, the boy developed prednisone-related facial swelling. After stopping prednisone, his symptoms relapsed. Subsequent treatment with omalizumab, combined with dietary intervention, showed good efficacy and safety. Conclusions To our knowledge, this is the first case of concurrent EoG and GSE that presented primarily with hypoproteinemia. We highlight the rare manifestations of these two diseases to raise clinical suspicion and prevent missed and delayed diagnoses. The pathogenesis of EoG is heterogeneous and complex. Omalizumab showed good efficacy, indicating that IgE-mediated processes may be involved in the pathogenesis of this patient’s diseases.

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A rare manifestation of IgG4-related disease and secondary hypereosinophilic syndrome: A case report

Takeuchi,

Shojima,

Matsueda

et al. 2024

Modern Rheumatology Case Reports

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We report a case of IgG4-related disease with marked eosinophilia. A 79-year-old woman was admitted due to diarrhea, and weight loss. Cervical lymphadenopathy, bilateral submandibular glands swelling, anemia (Hb8.5g/dl), hypereosinophilia (9,750/μL), and elevated serum creatinine (1.57 mg/dL), pancreatic amylase (191 IU/L), and IgG4 (3,380 mg/dL) were found. Diffusion-weighted image on MRI showed high intensity signals inside of both the pancreas and the kidney. The echogram of submandibular glands revealed cobblestone pattern. Kidney biopsy revealed acute tubulointerstitial nephritis. Biopsies of lip, gastrointestinal tract and bone marrow showed infiltration of lymphoplasmacytic cells and IgG4 positive plasma cells (30-67/HPF). Gastrointestinal and bone marrow biopsies also showed eosinophilic infiltration. Adrenal insufficiency, rheumatic disease, tuberculosis, parasite infection, drug induced eosinophilia, and eosinophilic leukemia were all ruled out. We started treatment with 40mg of prednisolone and her general condition rapidly improved. The eosinophil count, serum IgG4, and serum creatinine decreased. We gradually tapered prednisolone and maintained 5mg/day. During the 5 years of treatment, she had no recurrence of the symptom. According to the 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-related disease, eosinophils > 3000/μL is one of the exclusion criteria. If we comply this criterion, the diagnosis of IgG4-related disease should be avoided. However, our case fit the diagnostic criteria of type I autoimmune pancreatitis, IgG4-related sialadenitis and global diagnosis of IgG4-related disease. We finally diagnosed our case as IgG4-related disease with secondary hypereosinophilic syndrome. This case suggests that IgG4-related disease with eosinophils > 3000/μL does exist in the real world.

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Eosinophilic gastroenteritis: Pathogenesis, diagnosis, and treatment

Cited by 10 publications

References 79 publications

Eosinophilic Enteritis Causing Recurrent Small Bowel Obstruction: A Case Report

Eosinophilic Enteritis Causing Recurrent Small Bowel Obstruction: A Case Report

Eosinophilic gastritis and gluten-sensitive enteropathy manifested as hypoproteinemia and treated with omalizumab: a case report

A rare manifestation of IgG4-related disease and secondary hypereosinophilic syndrome: A case report

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