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Case Reports
. 2022 Sep 6;30(Suppl 2):52-56.
doi: 10.1159/000525809. eCollection 2023 Nov.

Eosinophilic Gastroenteritis: Still a Diagnostic Challenge

Sofia Silva Mendes  1   2 , Bruno Gonçalves  1 , João Bruno Soares  1 , Ana Célia Caetano  1   2 , Raquel Gonçalves  1
Affiliations
Case Reports

Eosinophilic Gastroenteritis: Still a Diagnostic Challenge

Sofia Silva Mendes et al. GE Port J Gastroenterol. .

Abstract
in English, Portuguese

Introduction: Eosinophilic gastroenteritis (EoG) is a rare condition with a yet poorly understood pathophysiology.

Case presentation: We report on a case of a 36-year-old woman with a history of atopy presenting with nausea, abdominal discomfort, weight loss, and ascites. Laboratorial analysis revealed peripheral eosinophilia and a slight elevation of inflammatory markers. The patient pursued medical assistance several times with a delay in the diagnosis. The pathway to the diagnosis of EoG with serosal infiltration and further management is presented.

Discussion: Despite being diagnosed by exclusion, it is important to suspect EoG with subserosa involvement in patients presenting with the uncommon association of peripheral eosinophilia and ascites, particularly if there is a history of atopy.

Introdução: A gastroenterite eosinofílica é uma condição rara, com uma etiologia ainda pouco compreendida.

Caso clínico: Uma mulher de 36 anos, com antecedentes de atopia, que se apresenta com náuseas, desconforto abdominal difuso, perda ponderal e ascite de novo. As análises laboratoriais revelaram eosinofilia periférica e ligeira elevação dos parâmetros inflamatórios. A doente recorreu a cuidados de saúde repetidamente sem um diagnóstico. É apresentado o percurso até ao diagnóstico de gastroenterite eosinofílica com infiltração serosa e tratamento subsequente.

Discussão: Apesar de ser um diagnóstico de exclusão, é importante suspeitar de gastroenterite eosinofílica com envolvimento subseroso perante a associação de ascite a sintomas gastrointestinais inespecíficos particularmente em doentes com história de atopia.

Keywords: Ascites; Eosinophilia; Eosinophilic enteropathy.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Thoracoabdominopelvic computerized tomography (CT) without lung alterations (a); distal esophagus wall thickening (b); and diffuse jejunal and ileal wall thickening (c).
Fig. 2
Fig. 2
Upper GI endoscopy with normal endoscopic appearance of gastric cardia and fundus (a), gastric antrum (b), and duodenum (c). Colonoscopy with ileoscopy with normal mucosa of the cecum (d, e) and terminal ileus (f).
Fig. 3
Fig. 3
Histopathologic images of endoscopic biopsies of duodenum (a) and ileum (b), HE. ×400, with infiltration of the lamina propria with eosinophils (>52 per HPF). Esophageal and colonic (c) biopsies with >10 eosinophils/HPF. HE, hematoxylin and eosin coloration.
See this image and copyright information in PMC

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