Milk-sensitive and eosinophilic gastroenteropathy: Similar clinical features with contrasting mechanisms and clinical course

Katz, Amos; Fj, Twarog; Zeiger, Robert S.; Zm, Falchuk

doi:10.1016/0091-6749(84)90090-3

Cited by 98 publications

(54 citation statements)

References 25 publications

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“…After cow’s milk had been determined to be the allergen causing EGE, strict elimination of this in the diet was carried out, which effectively prevented EGE recurrence. An elimination diet may be successful if a limited number of food allergies are identified [32,33,34,35]. In contrast, avoiding foods that are thought to trigger a reaction has shown little or no clinical benefit for EGE patients with suspected food sensitivities [36].…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic Gastroenteritis due to Cow’s Milk Allergy Presenting with Acute Pancreatitis

Suzuki¹,

Homma²,

Kurokawa³

et al. 2012

Int Arch Allergy Immunol

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Eosinophilic gastroenteritis (EGE) is characterized by eosinophilic infiltration of the digestive organs, most commonly of the stomach and the duodenum. Symptoms of EGE are nonspecific and include nausea, vomiting, abdominal pain, dyspepsia, malabsorption, ascites and weight loss. The various symptoms of EGE depend on its location and the depth of gastrointestinal eosinophil infiltration. We report a case presenting with acute pancreatitis caused by a milk allergy. The patient’s symptoms rapidly improved after treatment with corticosteroids, and he remained symptom-free for more than 20 months by the elimination of cow’s milk from his diet. Serum titers of pancreatic enzymes and total bilirubin simultaneously recovered and blood eosinophil counts normalized. The causative allergens of EGE are too various to detect; however, allergologic exams revealed that a cow’s milk allergy had provoked EGE in our case. Adult-onset cow’s milk allergies are rare; when seen, however, they may present severe complications such as anaphylaxis, gastroenteritis and pancreatitis. When unaccountable gastrointestinal symptoms are observed, EGE caused by food allergies should be included in the differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Eosinophilic Gastroenteritis due to Cow’s Milk Allergy Presenting with Acute Pancreatitis

Suzuki¹,

Homma²,

Kurokawa³

et al. 2012

Int Arch Allergy Immunol

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“…In older children and adults, the inciting factor(s) leading to the intestinal eosinophilia usually is (are) unknown. 1,2 Recently, Desreumaux et al 3 have suggested that the persistence of intestinal eosinophilia in eosinophilic gastroenteropathy may be caused by autocrine and/or paracrine activities of the eosinophil, although the trigger for these activities remains obscure. Traditionally, T lymphocytes are considered the primary coordinators of intestinal inflammation with eosinophils being recruited secondarily into the inflammatory regions 4 after helper T-cell activation or an imbalance of the Th1 and Th2 cytokine profile regulating the inflammatory response.…”

confidence: 99%

Posttransplant eosinophilic gastroenteritis in children

et al. 1997

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The cause of eosinophilic gastroenteropathy in older children and adults is unknown. In this report, two post-liver transplantation children treated with low-dose cyclosporine A and alternate-day low-dose prednisone are described who were administered a single bolus administration of a lympholytic dose of corticosteroids without taper and who developed intestinal symptomatology several weeks later. Histologic examination of mucosal biopsy specimens from various regions of the gastrointestinal tract showed an intense eosinophilic infiltration of the mucosa and lamina propria. The patients recovered after corticosteroid administration was tapered. Post-transplant gastroenteric eosinophilic inflammation may need to be considered in patients on immunomodulatory medications who have chronic intestinal symptomatology.

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“…The clinical presentations of eosinophilic enteritis depend on the site of involvement with eosinophilic enterits being asymptomatic or symptomatic. Symptomatic cases may present as chronic anemia, subacute intestinal obstruction due to strictures, acute obstruction due to intussusceptions or chronic abdominal pain [1,2,6] . Enteroliths, the endogenous foreign bodies, were first described by Pfahler and Stamm in 1915.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is likely that they are indeed distinct entities in most patients. These diseases are characterized by the selective infiltration of eosinophils in the stomach, small intestine, or both, with variable involvement of the esophagus, large intestine, or both [5,6] . It is now appreciated that many disorders are accompanied by eosinophil infiltration in the stomach, such as parasitic and bacterial infections (including Helicobacter pylori), IBD, hypereosinophilic syndrome (HES), eosinophilic enteritis, periarteritis, allergic vasculitis, scleroderma, drug injury, and drug hypersensitivity [7] .…”

Section: Discussionmentioning

confidence: 99%

Enterolithiasis complicating eosinophilic enteritis: A case report and review of literature

Shivathirthan¹,

Maheshwari²,

Kamath³

et al. 2009

WJGS

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We report a case of eosinophilic enteritis involving the proximal small bowel, a relatively rare entity, presenting unusually as enteroliths in a 68-year-old man with complaints of anemia, malena and abdominal pain. The disease if diagnosed in the initial stages responds well to medical treatment but if associated with complications or misdiagnosed, surgical modality is the treatment of choice. In our case, the patient presented with enteroliths and strictures. Resection and anastomosis of the small bowel containing stones was carried out. Histopathology confirmed the diagnosis as eosinophilic enteritis.

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Milk-sensitive and eosinophilic gastroenteropathy: Similar clinical features with contrasting mechanisms and clinical course

Cited by 98 publications

References 25 publications

Eosinophilic Gastroenteritis due to Cow’s Milk Allergy Presenting with Acute Pancreatitis

Eosinophilic Gastroenteritis due to Cow’s Milk Allergy Presenting with Acute Pancreatitis

Posttransplant eosinophilic gastroenteritis in children

Enterolithiasis complicating eosinophilic enteritis: A case report and review of literature

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