Clinical Analysis of 24 Cases of Eosinophilic Gastroenteritis / 胃肠病学

ABSTRACT

Background: Eosinophilic gastroenteritis (EGE) is a rare gastrointestinal disorder characterized by eosinophilic infiltration of the gastrointestinal tract. Up to now, most of the knowledge of EGE is based on single case reports and small sample studies at home and abroad. Aims: To study the clinical manifestations, endoscopic characteristics, histo-pathological features, as well as treatment and relapse of EGE. Methods: A retrospective analysis was conducted on the clinical data of patients with EGE from Nov. 2008 to Jun. 2018 at the Xijing Hospital of Digestive Diseases. Results: Twenty-four patients with EGE were identified (mean age 44.4 years). The disease affected both males and females with a slight male predominance (1.41). Atopy or allergic disorders were present in 5 cases (20.8%); 13 cases (54.2%) had obvious inducing factors, including 11 cases related to improper eating. Most common symptoms were abdominal pain (66.7%) and diarrhea (58.3%). Peripheral eosinophilia occurred in 14 patients (58.3%). Abdominal ultra-sonography/CT demonstrated 3 cases of massive ascites. Mucosal congestion, edema, erosion and ulcer were the predominant features seen on endoscopy. The colorectum (80.0%), terminal ileum (80.0%) and duodenum (75.0%) were the most common sites involved in biopsy pathology. Based on depth of eosinophilic infiltration, 19 were mucosal (79.2%), 2 were muscularis (8.3%), and 3 were subserosal diseases (12.5%). Glucocorticoids combined with symptomatic treatment could rapidly improve symptoms, however, the recurrence rate (mainly due to improper eating and drug withdrawal) was substantially high (52.6%). Conclusions: EGE is a rare condition with high relapse rate. Glucocorticoids with symptomatic treatment are effective in relieving symptoms. When EGE is suspected, both gastroscopy and colonoscopy should be performed and multiple biopsies should be taken, especially in colorectum, terminal ileum and duodenum to improve the detection rate.