Abstract
Eosinophilic gastroenteritis (EG) is a rare disease that is characterized by an eosinophil-driven inflammation of the digestive tract, presenting with gastrointestinal symp­toms. In this report, a case of EG in an elderly man who presented with diarrhea was presented. A 68-year-old man admitted to hospital due to diarrhea, nausea, abdominal pain, and weight loss started two weeks ago. Hypereosinophilia were determined. Serum immunoglobulin E level was high. Stool examinations for intestinal parasites were negative. Biopsies were taken from esophagus, stomach, duodenum during upper and lower gastrointestinal endoscopies. Histopathological as­sessement showed an intense edema, eosinophilic and increased lymphoplasmasitic infiltration in lamina propria. Increased eosinophil count seen in bone-marrow biopsy, atypical cell was not seen. Eosinophilic gastroenteritis was considered and, ketotifen 2 mg/day and methylpred­nisolone 1 mg/kg/day were started. His symptoms were improved. Gastrointestinal symptoms of EG are nonspecific. The increase of eosinophilic cells in the circulating blood can suggest the possibility of EG. Definite diagnosis is made by histopathological assessment. Glucucorticoid therapy is the mainstay and is effective in the treatment of EG. However, the antihistamines are also used solely or com­bined with glucocorticoids.
References
- Whitaker IS, Gulati A, McDaid JO, Bugajska-Carr U, Arends MJ. Eosinophilic gastroenteritis presenting as obstructive jaundice. Eur J Gastroenterol Hepatol 2004;16 (5):407-9.
- Dursun M, Yılmaz Ş, Canoruç F, Sarı Y. Eozinofilik gastro- enterit: assit ile başvuran bir vaka. Turkiye Klinikleri Gas- troenterohepatoloji Dergisi 2003;14(2):195-7.
- Verheijden NA, Ennecker-Jans SA. A rare cause of ab- dominal pain: Eosinophilic gastroenteritis. Neth J Med 2010;68(4):367-9.
- Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004;113 (1):11-28.
- Fleischer DM, Atkins D. Evaluation of the patient with sus- pected eosinophilic gastrointestinal disease. Immunol Al- lergy Clin North Am 2009;29(1):53-63.
- Straumann A, Simon HU. The physiological and pathophysi- ological roles of eosinophils in the gastrointestinal tract. Al- lergy 2004;59 (1):15–25.
- Talley NJ, Shorter RG, Phillips SF, Zinsmeister AR. Eosino- philic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues. Gut 1990;31(1):54–8.
- Khan S. Eosinophilic gastroenteritis. Gastroenterol Clin North Am 2008;37(1):333-48.
- Bolukbas FF, Bolukbas C, Uzunkoy A, Baba F, Horoz M, Öztürk G. A dramatic response to ketotifen in case of eo- sinophilic gastroenteritis mimicking abdominal emergency. Dig Dis Sci 2004;49(12):1782-5.
- Erdem L, Akbayır N. Eozinofilik gastroenterit. Güncel Gas- troenteroloji Dergisi 2004;8(3):252-60.
Abstract
Eozinofilik gastroenterit (EGE), gastrointestinal semptom­lara yol açan sindirim kanalının eozinofilik infiltrasyonu ile karakterize nadir bir hastalıktır. Bu yazıda ishal nedeni araştırılırken teşhis edilen yaşlı bir EGE vakasını sunul­muştur. Altmış sekiz yaşında erkek hasta; yaklaşık 2 hafta önce başlayan iştahsızlık, ishal, karın ağrısı, kilo kaybı nede­niyle hastanemize başvurdu. Hastanın tam kan sayı­mında bariz eozinofili mevcuttu. Serum immünglobulin E düzeyi yüksekti. Gaita incelemelerinde parazit görülme­di. Özofagus, mide, duodenum ve rektumdan alınan bi­yopsilerin histopatolojik incelemesinde lamina propriada yoğun ödem ve eozinofil infiltrasyonun eşlik ettiği lenfop­lazmositer hücre infiltrasyonu mevcuttu. Eozinofil artışı ile seyreden hipersellüler kemik iliği saptandı, atipik hücre yoktu. Hastada eozinofilik gastroenterit düşünüldü. Keto­tifen 2 mg/gün ve metilprednizolon 1 mg/kg/gün başlandı. Semptomları düzeldi. Eozinofilik gastroenteritte semptomlar hastalığa özgü de­ğildir. Periferik eozinofili hastalığı düşündürür. Kesin teşhis histopatolojik incelemeyle konur. Tedavisinde glukokorti­koid tedavi ana unsurdur ve etkilidir. Antihistaminikler de yalnız veya glukokortikoidlerle birlikte kullanılmaktadır.
References
- Whitaker IS, Gulati A, McDaid JO, Bugajska-Carr U, Arends MJ. Eosinophilic gastroenteritis presenting as obstructive jaundice. Eur J Gastroenterol Hepatol 2004;16 (5):407-9.
- Dursun M, Yılmaz Ş, Canoruç F, Sarı Y. Eozinofilik gastro- enterit: assit ile başvuran bir vaka. Turkiye Klinikleri Gas- troenterohepatoloji Dergisi 2003;14(2):195-7.
- Verheijden NA, Ennecker-Jans SA. A rare cause of ab- dominal pain: Eosinophilic gastroenteritis. Neth J Med 2010;68(4):367-9.
- Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004;113 (1):11-28.
- Fleischer DM, Atkins D. Evaluation of the patient with sus- pected eosinophilic gastrointestinal disease. Immunol Al- lergy Clin North Am 2009;29(1):53-63.
- Straumann A, Simon HU. The physiological and pathophysi- ological roles of eosinophils in the gastrointestinal tract. Al- lergy 2004;59 (1):15–25.
- Talley NJ, Shorter RG, Phillips SF, Zinsmeister AR. Eosino- philic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues. Gut 1990;31(1):54–8.
- Khan S. Eosinophilic gastroenteritis. Gastroenterol Clin North Am 2008;37(1):333-48.
- Bolukbas FF, Bolukbas C, Uzunkoy A, Baba F, Horoz M, Öztürk G. A dramatic response to ketotifen in case of eo- sinophilic gastroenteritis mimicking abdominal emergency. Dig Dis Sci 2004;49(12):1782-5.
- Erdem L, Akbayır N. Eozinofilik gastroenterit. Güncel Gas- troenteroloji Dergisi 2004;8(3):252-60.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Reports |
| Authors | |
| Publication Date | June 1, 2011 |
| Submission Date | March 2, 2015 |
| Published in Issue | Year 2011 Volume: 38 Issue: 2 |