Eosinophilic disorders of the gastrointestinal tract: clinical manifestations, diagnosis and treatment

Abstract

Eosinophilic gastrointestinal disorders (EGID) are a kind of pathology which has not been well studied and has a trend to an increase during the last years that raises concern. They may have highly variable clinical manifestations; therefore, their differential diagnosis is not infrequently challenging. The article presents a review of scientific data on EGID and three clinical cases of various eosinophilic lesions of the stomach and gut in children. Clinical manifestations of EGID depend on their location and on the depth of the lesions. The first clinical case presented with repeated gastrointestinal bleedings in a child with hemorrhagic eosinophilic gastritis. The second clinical case was eosinophilic colitis with Crohnlike clinical and endoscopic manifestations, and the third one was eosinophilic ileocolitis with ascites. All these children had a background of sensitization to various food allergens. However, there were no high specific IgE in blood in any of the cases, although IgE were identified in the biopsy sample of intestinal mucosa and in duodenal aspirates. The results of the mast cell degranulation test with corresponding allergens correlated with the efficacy of their elimination. Elimination diet was recommended to all the patients; in two patients it was combined with a short course of glucocorticosteroids and in one case with subsequent montelucast treatment. All three patients achieved complete recovery, confirmed by their follow-up and repeated endoscopic and histological examinations.

Keywords

• eosinophilic gastritis
• eosinophilic gastroenteritis
• eosinophilic colitis
• eosinophilic gastrointestinal disorder