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Kronik İshalin Nadir Bir Sebebi: Eozinofilik Kolit

Yıl 2020, Cilt: 11 Sayı: 41, 84 - 86, 01.12.2020
https://doi.org/10.17944/mkutfd.790823

Öz

Amaç: Eosinofilik kolit (EK) kronik ishalin nadir ancak hayat kalitesi üzerine uzun süreli olumsuz etkileri nedeniyle önemli bir sebebidir. Ülkemizden EK ile ilgili yayınlar sınırlı olup, bu yazıda kliniğimiz bu konudaki verilerinin paylaşılması amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya Mayıs 2016 ve Haziran 2020 tarihleri arasında kronik ishal etyolojisi araştırılmak üzere kolonoskopi yapılan ve patolojik inceleme sonucu EK tanısı konan vakalar dahil edildi. Hastaların demografik özellikleri, klinik özellikleri, labaratuvar değerleri, kolonoskopik ve patolojik verileri retrospektif olarak incelendi.
Bulgular: Çalışmaya 22 erkek ve 14 kadın olmak üzere toplam 36 vaka dahil edildi. Erkeklerin yaş ortalaması 42.6 (23-67) ve kadınların yaş ortalaması 52.2 yıl (18-75) idi. Başlıca klinik başvuru sebepleri ishal, karın ağrısı ve rektal kanama idi. Tanı öncesi şikayet süresi ortalama 13,7 ay (2-48) ve tanı sonrası ortalama takip süresi 16.5 ay (2-49) idi. Periferik euzonofili 7/36 vakada saptandı. Tüm hastalara metilprednisolon 16-32 mg/gün dozunda verildi.
Tartışma ve sonuç: EK kronik ishalin hayat kalitesini etkileyen önemli bir sebebidir. Metilprednisolon tedavisi son derece etkili ve güvenlidir. Klinik şüphe ve kolonoskopik biyopsilerin histopatolojik incelenmesi tanı için en önemli faktörlerdir.

Kaynakça

  • Yüksel ES, Topal F. Kronik diyare nedenleri. Güncel Gastroenteroloji 2017;21(2):101-7.
  • Headstrom PD, Surawicz CM. Chronic diarrhea. Clin Gastro Hep 2005;3:734-7. https://doi.org/10.1016/S1542-3565(05)00298-3
  • Vikas U, Portia K, Erika K. Eosinophilic gastroenteritis and colitis: a comprehensive review. Clin Rev Allergy Immunol 2016;50(2):175-88. https://doi.org/10.1007/s12016-015-8489-4
  • Kuzu UB, Köksal AŞ. Eozinofilik gastrointestinal hastalıklar. Güncel Gastroenteroloji 2014;18(3):342-51.
  • Weshil BK, Walker A. The mucosal barrier, Ig E mediated gastrointestinal events and eosinophilic gastroenteritis. Gastroent Clin North Am 1992;21:387-404.
  • Khan S. Eosinophilic gastroenteritis. Best Pract Res Clin Gastroenterol 2005;19:177-98. https://doi.org/10.1016/j.bpg.2005.01.009
  • Rothenberg ME. Eosinophilic gastrointestinal disorders. J Allergy Clin Immunol 2004;113:11-28. https://doi.org/10.1016/j.jaci.2003.10.047
  • Ertuğrul I, Ulker A, Turhan N, Dağli U, Saşmaz N. Eosinophilic colitis as an unusual cause of severe bloody diarrhea. Turk J Gastroenterol 2008;19(1):54-6.
  • Kefeli A, Akturk A, Başyiğit S. Eosinophilic colitis complicated with renal infarction. Am J Emerg Med 2015;33(11):1703-4. https://doi.org/10.1016/j.ajem.2015.07.084
  • Walker MM , Potter MD, Talley NJ. Eosinophilic colitis and colonic eosinophilia. Curr Opin Gastroenterol 2019;35(1):42-50. https://doi.org/10.1097/MOG.0000000000000492
  • Jensen ET, Martin CF , Kappelman MD, Dellon ES. Prevalence of eosinophilic gastritis, gastroenteritis, and colitis: estimates from a national administrative database. J Pediatr Gastroenterol Nutr 2016;62(1):36-42. https://doi.org/10.1097/MPG.0000000000000865
  • Talley NJ, Shorter RG, Phillips SF, Zinsmeister AR. Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, musclelayer and subserosal tissues. Gut 1990;31:54-8. https://doi.org/10.1136/gut.31.1.54
  • Impellizzeri G, Marasco G, Eusebi LH, Salfi N, Bazzoli F, Zagari RM. Eosinophilic colitis: a clinical review. Dig Liver Dis 2019;51(6):769-73. https://doi.org/10.1016/j.dld.2019.04.011
  • Koçak G, Koçak E, Akbal E, Şen H, Erbağ G, Erdoğan C. Eosinophilic colitis: a rare cause of lower gastrointestinal bleeding in an elderly adult. J Am Geriatr Soc 2014;62(10):2016-7. https://doi.org/10.1111/jgs.13043
  • Tien FM, Wu JF, Jeng YM, Hsu HY, Ni YH, Chang MH, et al. Clinical features and treatment responses of children with eosinophilic gastroenteritis. Pediatr Neonatol 2011;52:272-8. https://doi.org/10.1016/j.pedneo.2011.06.006
  • Del Arco CD, Taxonera C, Olivares D, Aceñero MF . Eosinophilic colitis: case series and literature review. Pathol Res Pract 2018;214(1):100-4. https://doi.org/10.1016/j.prp.2017.09.029
  • Alfadda AA, Storr MA, Shaffer EA. Eosinophilic colitis: an update on pathophysiology and treatment. Br Med Bull 2011;100:59-72. https://doi.org/10.1093/bmb/ldr045
  • Okpara N, Aswad B, Baffy G. Eosinophilic colitis. World J Gastroenterol 2009;28:15(24):2975-9. https://doi.org/10.3748/wjg.15.2975

A Rare Cause of Chronic Diarrhea: Eosinophilic Colitis

Yıl 2020, Cilt: 11 Sayı: 41, 84 - 86, 01.12.2020
https://doi.org/10.17944/mkutfd.790823

Öz

Aim: Eosinophilic colitis (EC), which is rare but has adverse effects on the quality of life, is an important reason for chronic diarrhea. However there is limited publishing related to EC in our country and here we aim to share our clinic’s data on this issue.
Material and Method: The subjects, who had colonoscopy and were diagnosed with EC with reference to pathological examination, were included to the study to analyse the chronic diarrhea aetiology between May 2016 and June 2020. Demographic qualifications, clinical features, laboratory results, colonoscopy and pathological data of the patients have been studied in as retrospectively.
Results: Totally 36 subjects including 22 men and 14 women, were involved into the study. The age average of men was 42.6 (23 to 67 ages) and the age average of women was 52.2 (18 to 75 ages). The main clinical application reasons were diarrhea, stomach ache and rectal bleeding. The complaint period before diagnosis is 13.7 months (2 to 48) and the follow-up period after diagnosis is 16.5 months (2 to 49). The peripheral eosinophilia was detected with 7 out 36 cases. Methylprednisolone was administrated by patients as 16 to 32 mg/day as a dosage.
Discussion and Conclusion: The EC is an important cause of chronic diarrhea that affects the quality of life. Methylprednisolone treatment is extremely efficient and safe. The clinical suspicion and examination of colonoscopy biopsy are important factors for diagnosis.

Kaynakça

  • Yüksel ES, Topal F. Kronik diyare nedenleri. Güncel Gastroenteroloji 2017;21(2):101-7.
  • Headstrom PD, Surawicz CM. Chronic diarrhea. Clin Gastro Hep 2005;3:734-7. https://doi.org/10.1016/S1542-3565(05)00298-3
  • Vikas U, Portia K, Erika K. Eosinophilic gastroenteritis and colitis: a comprehensive review. Clin Rev Allergy Immunol 2016;50(2):175-88. https://doi.org/10.1007/s12016-015-8489-4
  • Kuzu UB, Köksal AŞ. Eozinofilik gastrointestinal hastalıklar. Güncel Gastroenteroloji 2014;18(3):342-51.
  • Weshil BK, Walker A. The mucosal barrier, Ig E mediated gastrointestinal events and eosinophilic gastroenteritis. Gastroent Clin North Am 1992;21:387-404.
  • Khan S. Eosinophilic gastroenteritis. Best Pract Res Clin Gastroenterol 2005;19:177-98. https://doi.org/10.1016/j.bpg.2005.01.009
  • Rothenberg ME. Eosinophilic gastrointestinal disorders. J Allergy Clin Immunol 2004;113:11-28. https://doi.org/10.1016/j.jaci.2003.10.047
  • Ertuğrul I, Ulker A, Turhan N, Dağli U, Saşmaz N. Eosinophilic colitis as an unusual cause of severe bloody diarrhea. Turk J Gastroenterol 2008;19(1):54-6.
  • Kefeli A, Akturk A, Başyiğit S. Eosinophilic colitis complicated with renal infarction. Am J Emerg Med 2015;33(11):1703-4. https://doi.org/10.1016/j.ajem.2015.07.084
  • Walker MM , Potter MD, Talley NJ. Eosinophilic colitis and colonic eosinophilia. Curr Opin Gastroenterol 2019;35(1):42-50. https://doi.org/10.1097/MOG.0000000000000492
  • Jensen ET, Martin CF , Kappelman MD, Dellon ES. Prevalence of eosinophilic gastritis, gastroenteritis, and colitis: estimates from a national administrative database. J Pediatr Gastroenterol Nutr 2016;62(1):36-42. https://doi.org/10.1097/MPG.0000000000000865
  • Talley NJ, Shorter RG, Phillips SF, Zinsmeister AR. Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, musclelayer and subserosal tissues. Gut 1990;31:54-8. https://doi.org/10.1136/gut.31.1.54
  • Impellizzeri G, Marasco G, Eusebi LH, Salfi N, Bazzoli F, Zagari RM. Eosinophilic colitis: a clinical review. Dig Liver Dis 2019;51(6):769-73. https://doi.org/10.1016/j.dld.2019.04.011
  • Koçak G, Koçak E, Akbal E, Şen H, Erbağ G, Erdoğan C. Eosinophilic colitis: a rare cause of lower gastrointestinal bleeding in an elderly adult. J Am Geriatr Soc 2014;62(10):2016-7. https://doi.org/10.1111/jgs.13043
  • Tien FM, Wu JF, Jeng YM, Hsu HY, Ni YH, Chang MH, et al. Clinical features and treatment responses of children with eosinophilic gastroenteritis. Pediatr Neonatol 2011;52:272-8. https://doi.org/10.1016/j.pedneo.2011.06.006
  • Del Arco CD, Taxonera C, Olivares D, Aceñero MF . Eosinophilic colitis: case series and literature review. Pathol Res Pract 2018;214(1):100-4. https://doi.org/10.1016/j.prp.2017.09.029
  • Alfadda AA, Storr MA, Shaffer EA. Eosinophilic colitis: an update on pathophysiology and treatment. Br Med Bull 2011;100:59-72. https://doi.org/10.1093/bmb/ldr045
  • Okpara N, Aswad B, Baffy G. Eosinophilic colitis. World J Gastroenterol 2009;28:15(24):2975-9. https://doi.org/10.3748/wjg.15.2975
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Original Articles
Yazarlar

Muhammed Sait Dağ 0000-0003-0033-8151

Yayımlanma Tarihi 1 Aralık 2020
Gönderilme Tarihi 5 Eylül 2020
Kabul Tarihi 19 Ekim 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 11 Sayı: 41

Kaynak Göster

Vancouver Dağ MS. Kronik İshalin Nadir Bir Sebebi: Eozinofilik Kolit. mkutfd. 2020;11(41):84-6.