[Eosinophilic gastroenteritis]

Abstract

Eosinophilic Gastroenteritis (EGE) is a disease of unknown etiology characterized by peripheral eosinophilia associated with eosinophilic infiltration of the layers of the wall of the gastrointestinal tract. Clinical manifestations are related to the level of histologic infiltration in the wall, and the segment of GI tract involved. Two cases of EGE are reported with different clinical presentations: One case is chronic, with recurrent ascites of 13 years duration and gastric outlet obstruction; the other case is acute with 14 days of abdominal symptoms and peripheral eosinophilia. We describe the diagnostic work-up and exclude other causes of eosinophilia. In case #1 with a chronic illness, the infiltration of the gastric wall was mainly of the muscular layer and serosa, and the clinical, radiological, endoscopic and surgical characteristics were of an infiltrative disease of the stomach, that was aggressively treated with total gastrectomy. The correct diagnosis in this case was established in the pathologic examination of the surgical specimen. In case #2 the disease was acute, the eosinophilic infiltrate was limited to the mucosa layer of the small and large bowel, and the diagnosis was established in an endoscopic biopsy specimen. Case #1 had a recurrence of ascites 5 years after total gastrectomy with peripheric and ascitic eosinophilia. Both cases were treated with low doses of Prednisone tapered off in a few days, with rapid clinical remission.