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Eosinophilic Gastroenteritis: An Underdiagnosed Condition

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Abstract

Background

Eosinophilic gastroenteritis (EOGE) is a rare idiopathic disease characterized by eosinophil-predominant inflammation of the stomach and/or intestines. Our aims are to determine the epidemiology, clinical features and outcomes of EOGE cases in a tertiary-care hospital.

Methods

Retrospective cohort study of patients with gastrointestinal eosinophilic infiltration from 2004 through 2014. All relevant specimens were reviewed by an expert pathologist. Significant eosinophilic infiltrate was defined as >25 eosinophils/HPF in the stomach or small intestine and >50 eosinophils/HPF in the colon.

Results

Three hundred and sixty-one charts were reviewed and 13 EOGE cases were identified, including nine adults and four pediatric cases. The majority (78 %) of adult cases were females. Clinical presentation was variable; most patients (62 %) had abdominal pain, followed by diarrhea (31 %) and nausea/vomiting (31 %). Atopy and food allergies were present in 54 and 38 % of patients, respectively. Weight loss and failure to thrive were present only in pediatric cases (50 vs 0 %; P = .01). Most EOGE cases (69 %) had peripheral eosinophilia, which was more prominent in patients with ascites compared to patients without ascites (37.3 ± 25.4 vs 9.3 ± 5.4 %; P = .01). Among patients who had long-term follow-up; 30 % had spontaneous remission, 60 % responded to steroids and/or restriction diet, and 10 % had refractory disease.

Conclusion

EOGE is an underdiagnosed condition. In contrast to eosinophilic esophagitis; the disease might be female-predominant in adults. High index of clinical suspicion is required for diagnosis. Further studies about the long-term outcomes and the efficacy of restriction diet in adult patients are required.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, MSC10-5550, University of New Mexico, Albuquerque, NM, USA

    Tarik Alhmoud & Gulshan Parasher

  2. Department of Pathology, University of New Mexico, Albuquerque, NM, USA

    Joshua Anspach Hanson

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  1. Tarik Alhmoud
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  2. Joshua Anspach Hanson
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Correspondence to Tarik Alhmoud.

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Alhmoud, T., Hanson, J.A. & Parasher, G. Eosinophilic Gastroenteritis: An Underdiagnosed Condition. Dig Dis Sci 61, 2585–2592 (2016). https://doi.org/10.1007/s10620-016-4203-5

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