Eosinophilic gastroenteritis: an unusual type of gastroenteritis

Abstract

Eosinophilic gastroenteritis (EGE) is a rare disorder characterized by eosinophilic infiltration of the bowel wall with various gastrointestinal manifestations. Till date only 280 cases have been described in the literature. A high index of suspicion, by excluding other causes of peripheral eosinophilia, is a pre requisite for accurate diagnosis. EGE is an uncommon gastrointestinal disease affecting both children and adults. It was first described by Kaijser in 1937. Presentation may vary depending on location as well as depth and extent of bowel wall involvement and usually runs a chronic relapsing course. This condition can respond to low dose steroid therapy, thereby preventing grave complications like ascites and intestinal obstruction that might need surgical intervention. The natural history of EGE has not been well documented. Eosinophilic gastroenteritis is a chronic, waxing and waning condition. Mild and sporadic symptoms can be managed with reassurance and observation, whereas disabling gastrointestinal (GI) symptom flare-ups can often be controlled with oral corticosteroids. When the disease manifests in infancy and specific food sensitization can be identified, the likelihood of disease remission by late childhood is high. GI obstruction is the most common complication. Fatal outcomes are rare.

Keywords: Eosinophilic gastroenteritis; Review of literature; Unusual type.

Figure 1

Endoscopy showing small superficial ulcers in stomach.

Figure 2

Large numbers of eosinophils are often present in the muscularis and serosa. A, B: Showing dense eosinophilic infiltrates in the lamina propria and mucosa (× 10); C: Showing dense eosinophilic infiltrates in the lamina propria and mucosa (× 40).

Figure 3

Post treatment (low dose steroid) biopsy showing resolution of disease.