A Case of Eosinophilic Esophagitis With Food Hypersensitivity

Eosinophilic esophagitis (EoE) is a disorder characterized by isolated eosinophilic infiltration of the esophagus with esophageal symptoms. Although some patients with EoE are related to food hypersensitivity, it is hard to identify causative foods. This report describes a case of EoE with dysphagia. A 28-year-old man presented with dysphagia and substernal discomfort for 15 days. He had taken a protein complex for 2 months. Endoscopy showed several linear furrows and multiple mucosal nodularities on the lower and mid esophagus, and the biopsies of esophagus revealed marked eosinophil infiltration in the mucosa. The skin testing for the protein complex was positive. The patient was successfully treated with withholding treatment.

Inflammatory Myoglandular Polyps Causing Hematochezia

We report herein three cases of inflammatory myoglandular polyp (IMGP) presenting as hematochezia. The polyps had pedunculated, red, and smooth features, and were 12, 12, and 15 mm in diameter and located in the sigmoid colon, transverse colon, and rectum, respectively. Endoscopic polypectomies were performed. Histologic examination of the recovered specimens revealed inflammatory granulation in the lamina propria mucosa, proliferation of smooth muscle, and hyperplastic glands with cystic dilatation. The three colon polyps were finally diagnosed both clinically and histologically as IMGP. Endoscopists should bear in mind that a polyp featuring endoscopic findings of pedunculation or semipedunculation; a red, smooth, spherical, and hyperemic surface; and patchy mucosa exudation and erosion is likely to be an IMGP.

A Case of Henoch-Schonlein Purpura with Cerebellar and Gastrointestinal Bleeding / 대한소화기내시경학회지

Henoch-Schonlein purpura is a systemic leukocytoclastic vasculitis involving small vessels. The diagnostic criteria is defined as a typical skin rash of which pathologic examination shows leukocytoclastic vasculitis, accompanied by any two of these major manifestations of the disease, namely gastrointestinal tract, kidney, joint involvement. In elder patient, Henoch-Schonlein purpura shows more serious gastrointestinal tract involvement. There are some reports of brain involvement of Henoch-Schonlein purpura. A 69-year-old man was admitted to department of neurosurgery, because of loss of consciousness. Brain CT showed acute cerebellar hemorrhage with rapid resolution by conservative treatment. Diffuse purpuric eruptions on both low legs were developed after 7 days of hospitalization. He was refered to our department due to epigastric pain and bloody diarrhea. There were multiple longitudinal ulcers with hemorrhage on the stomach and the sigmoid colon of which biopsy showed leukocytoclastic vasculitis. Microscopic hematuria and proteinuria were also noted. He had a fatal course due to recurrent colonic bleeding and poor medical condition. We report an unusual case of cerebellar and gastrointestinal involvement of Henoch-Schonlein purpura in elderly patient.