Clinical analysis of eosinophilic gastroenteritis in children / 中国小儿急救医学

ABSTRACT

Objective To discuss the clinical manifestations, laboratory indexes, imageological ex-amination results,endoscopic and histopathological features of eosinophilic gastroenteritis( EG) in children. Methods Thirty-three children with EG were collected with clinical manifestations,allergic history,labora-tory examination,endoscopic and histopathological features and treatments,who were hospitalized at depart-ment of pediatric gastroenterology of Shengjing Hospital of China Medical University between January 2012 and December 2017. Results The main clinical manifestations of EG were abdominal pain(75. 8％),vomi-ting(30. 3％)and diarrhea(21. 2％). The hemoglobin level decreased in 7 cases(21. 2％). The eosinophil count increased in 13 cases ( 39. 4％) . Total serum IgE elevated in 18 cases ( 54. 5％) , while 23 cases were positive in serum food or respiratory specific IgE. The fecal occult blood test showed positive in 7 cases (21. 2％). Among 28 children conducted with whole abdominal CT,there were 13 cases of pelvis fluid, 12 cases of enlarged lymph nodes and 4 cases of thickened intestinal wall. All 33 children went through the endoscopic examination,the main histological change were erythema-exudation(31 cases,93. 9％),mucosal hyperemia edema(5 cases,15. 2％) and hemorrhage(4 cases,12. 1％). The main pathological change was mucosal inflammation with a large number of eosinophil infiltration(≥20 per HPF) . Among the 33 cases,17 cases relieved through treatment of avoiding allergen, antacids, anti-allergic agents and leukotriene receptor antagonist,with 1 case recurrence. The other 16 cases relieved after treatment of glucocorticoid and the above therapy,with 3 cases recurrence. Conclusion The clinical manifestations of children with EG are various and lack of specificity. In terms of diagnosis,the elevated level of eosinophil count and total serum IgE,or posi-tive in serum food specific IgE may be taken as reference. The definite diagnosis is based on pathological examination (eosinophil infiltration≥20 per HPF). For treatment,avoiding allergen,antacids,anti-allergic agents and leukotriene receptor antagonist are effective in several children. Glucocorticoid can obtain satisfac-tory curative effect in the uneffective children.