ABSTRACT
Los trastornos eosinofílicos primarios del tracto gastrointestinal abarcan una serie de enfermedades crónicas que cursan con un infiltrado eosinofílico a nivel intestinal en ausencia de otras causas de eosinofilia. Pueden afectar a cualquier área del tubo digestivo, siendo excepcional la afectación exclusiva del colon. Dada su baja prevalencia no suelen tenerse en cuenta en el diagnóstico diferencial de los pacientes con diarrea crónica, por lo que en muchos casos la demora diagnóstica puede ser de años. Describimos el caso de una paciente con enfermedad celíaca bien controlada y diarrea crónica de origen indeterminado que fue finalmente diagnosticada de una colitis eosinofílica. Recibió tratamiento con budesonida oral con muy buena respuesta clínica y en la actualidad se mantiene asintomática
Primary eosinophilic gastrointestinal disorders include a spectrum of inflammatory chronic diseases in which eosinophils infiltrate the gut in the absence of known causes of such tissue eosinophilia. They may affect any area of the gastrointestinal tract although exclusive colonic disease is exceptional. Due to their low prevalence these disorders are not usually taken into account when making a differential diagnosis in a patient with chronic diarrhea, which is the reason why in many cases the diagnosis can take many years. We describe the case of a patient with well-controlled celiac disease and chronic diarrhea of indeterminate origin. The final diagnosis was eosinophilic colitis. A complete response was obtained when she was treated with oral budesonide. Nowadays she remains asymptomatic
Subject(s)
Humans , Female , Aged , Colitis/immunology , Eosinophilia/immunology , Celiac Disease/diagnosis , Diagnosis, Differential , Diarrhea/etiology , Chronic Disease , Budesonide/therapeutic useABSTRACT
Primary eosinophilic gastrointestinal disorders include a spectrum of inflammatory chronic diseases in which eosinophils infiltrate the gut in the absence of known causes of such tissue eosinophilia. They may affect any area of the gastrointestinal tract although exclusive colonic disease is exceptional. Due to their low prevalence these disorders are not usually taken into account when making a differential diagnosis in a patient with chronic diarrhea, which is the reason why in many cases the diagnosis can take many years. We describe the case of a patient with well-controlled celiac disease and chronic diarrhea of indeterminate origin. The final diagnosis was eosinophilic colitis. A complete response was obtained when she was treated with oral budesonide. Nowadays she remains asymptomatic.
Subject(s)
Celiac Disease/complications , Colitis/etiology , Enteritis/etiology , Eosinophilia/etiology , Gastritis/etiology , Aged , Female , HumansABSTRACT
Cholesterol crystal embolization has been considered an unusual entity with poor short term prognosis. However, it is an underestimated complication according to post-mortem findings. Patients have quite characteristic risk and precipitating factors which may be an aid to suspect the diagnosis. Gastrointestinal bleeding of different severity occurs in only 10% of patients with visceral embolization. We present the case of a patient with massive lower gastrointestinal bleeding secondary to several ulcerations in the hepatic flexure due to bowel cholesterol embolization.
