Diagnosis and treatment of eosinophilic gastroenteritis with massive ascites as the initial symptom in 6 children / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the clinical manifestations and endoscopic characteristics of eosinophilic gastroenteritis(EG) with massive ascites as the initial symptom and accumulate the experiences of EG for early diagnosis and treatment.Methods Clinical characteristics,laboratory examination,endoscopic features and treatment methods of 6 cases of pediatric patients with EG from Nanjing Children's Hospital Affiliated to Nanjing Medical University from May 2009 to Dec.2012 were analyzed.Results The main clinical manifestations of 6 cases with EG serous type were abdominal distension,ascites.Peripheral blood eosinophil (EOS) counts was increased significantly (5.1 × 109/L-20.6 × 109/L).A large number of EOS were found in ascitic fluid of 6 patients.Endoscopic manifestations was gastric mucosal hyperemia and edema in the all of 6 patients,and furthermore,gastric mucosa erosion in 2 cases,esophagus mucosa rough edema in 1 case,duodenal mucosal hyperemia and edema in 3 cases,duodenal nodular hyperplasia in 1 case.The mucosa pathological examination of 6 cases showed eosinophilia.Symptoms in patients were relieved after avoiding suspicious food and oral corticosteroids treatment after 1 week.Conclusions EG serous type patients in children are massive ascites as the initial symptom.Ascitic fluid and peripheral blood EOS counts are increased significantly and endoscopic feature is nonspecific,mucosal hyperemia,edema,erosions,nodular hyperplasia.EOS infiltration is observed in the gastrointestinal mucosa propria by multipoint biopsy.Therapeutic effect of diet therapy and the treatment of glucocorticoid is good.