Eozinofilik Gastroenterit

Year 2022, , 81 - 87, 31.12.2022

Selim Can Peker , Abdulbaki Erkovan , Mustafa Uğur Gunturk Ibrahim Kılıccalan

https://doi.org/10.35514/mtd.2022.79

Abstract

Eozinofilik gastroenteritis, mide ve ince bağırsakta yoğun eozinofili ile karakterize, Th2 aracılı alerjik bir hastalıktır. İlk olarak 1937 yılında tanımlanmasına rağmen patogenezi hala net olarak ortaya konamamıştır. Eozinofilik gastroenteritis, eozinofilik gastrointestinal bozuklar grubu içinde yer alır ve eozinofilik gastrit, eozinofilik enterit, eozinofilik kolit olmak üzere üç alt tipe ayrılır. Eozinofilik gastroenteritin en belirgin özelliği dokuda eozinofili tablosudur. Eozinofilik gastroenteriin klinik bulguları, gastrointestinal sistemdeki tutulum yerine ve bağırsak duvarında invazyon derinliğine göre farklılık gösterebilmektedir. Bununla birlikte en sık izlenen klinik belirtiler abdominal ağrı, bulantı, kusma, diare, kilo kaybı, gastrointestinal kanamadır. Tanısında anamnez, fizik muayene ve laboratuvar tetkikleri kullanılmaktadır. Eozinofilik gastroenteritis nadir izlenen bir hastalık olduğundan tanıda spesifik tanı kriterleri bulunmamaktadır. Ancak tanı sırasında dört ana kriterin varlığı önemlidir. Bu kriterler; gastroinsetinal semptomların bulunması, gastrointestinal sistemin eozinofilik infiltrasyonu, bağırsak eozinofilisinin diğer nedenlerinin (paraziter enfeksiyonlar, ilaçların yan etkileri, inflamatuar bağırsak hastalığı (IBD), bağ dokusu hastalıkları ve lenfoproliferatif maligniteler) dışlanması ve diğer sistemlerde tutulumun gözlenmemesi şeklindedir. Kesin tanı için klinik öykü, fizik muayene, laboratuar sonuçları, endoskopik ve radyolojik bulgular kullanılır. Eozinofilik gastroenterit tedavisinde diyet tedavisi, glukokortikoidler, immünsupresif ajanlar, mast hücresi stabilizatörleri, lökotrien antagonistleri, anti-IL5 antikoru, Anti-IgE antikoru gibi ajanlar kullanılmaktadır.

Keywords

Abdominal ağrı, eozinofili, eozinofilik gastroenterit, kortikosteroidler

Eosinophilic Gastroenteritis

Abstract

Eosinophilic gastroenteritis is a Th2 mediated allergic disease characterized by intense eosinophilia in the stomach and small intestine. Although it was first described in 1937, its pathogenesis is still not clearly established. Eosinophilic gastroenteritis is included in the group of eosinophilic gastrointestinal disorders and is divided into three subtypes: eosinophilic gastritis, eosinophilic enteritis, and eosinophilic colitis. The most prominent feature of eosinophilic gastroenteritis is tissue eosinophilia. Clinical manifestations of eosinophilic gastroenteritis may differ depending on the site of involvement in the gastrointestinal system and the depth of invasion in the intestinal wall. However, the most common clinical symptoms are abdominal pain, nausea, vomiting, diarrhea, weight loss, and gastrointestinal bleeding. Anamnesis, physical examination and laboratory tests are used in its diagnosis. Since eosinophilic gastroenteritis is a rare disease, there are no specific diagnostic criteria for diagnosis. However, the presence of four main criteria is important for diagnosis. These criteria are; Presence of gastroinsetinal symptoms, eosinophilic infiltration of the gastrointestinal tract, exclusion of other causes of intestinal eosinophilia (parasitic infections, side effects of drugs, inflammatory bowel disease (IBD), connective tissue diseases and lymphoproliferative malignancies) and absence of involvement in other systems. Clinical history, physical examination, laboratory results, endoscopic and radiological findings are used for definitive diagnosis. Agents such as diet therapy, glucocorticoids, immunosuppressive agents, mast cell stabilizers, leukotriene antagonists, anti-IL5 antibodies and anti-IgE antibodies are used in the treatment of eosinophilic gastroenteritis.

Keywords

Eosinophilic gastroenteritis, Eosinophili, Abdominal Pain, Corticosteroids

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