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Eosinophilic gastrointestinal disorder preceding Sjögren's syndrome. Joint Bone Spine 2016; 84:109-110. [PMID: 27131745 DOI: 10.1016/j.jbspin.2015.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 12/23/2015] [Indexed: 11/20/2022]
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Lecouffe-Desprets M, Groh M, Bour B, Le Jeunne C, Puéchal X. Eosinophilic gastrointestinal disorders associated with autoimmune connective tissue disease. Joint Bone Spine 2015; 83:479-84. [PMID: 26709253 DOI: 10.1016/j.jbspin.2015.11.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 11/03/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To determine the clinical and pathological characteristics of eosinophilic gastrointestinal disease (EGID) associated with autoimmune connective tissue disease (CTD). METHODS Systematic literature review. RESULTS Twenty cases of CTD associated with EGID were identified. Systemic lupus erythematosus was the main EGID-associated CTD (35%), followed by rheumatoid arthritis (20%), systemic sclerosis or inflammatory myopathies (15%, each), and Sjögren's syndrome, scleromyositis or other overlapping connective tissue disease (5%, each). No patient had a history of atopy. In contrast with classical EGID among which eosinophilic esophagitis is the most frequent type, eosinophilic gastritis and/or enteritis represented 95% of cases. Gastrointestinal symptoms were often unspecific. Peripheral eosinophilia was found in 67% of cases. Upper and lower gastrointestinal endoscopy showed abnormal findings in only 40% and 30% of cases, respectively. EGID was confirmed by evidence of digestive eosinophilic infiltration, mainly in mucosal or submucosal layer. In all but one patient, the CTD was diagnosed prior to the occurrence of the EGID. In total, 95% of EGID had a favorable outcome, with corticosteroids being used in almost all cases. CONCLUSION Clinicians should consider EGID as a possible diagnosis and perform gastrointestinal tract biopsies in patients with CTD presenting with gastrointestinal symptoms and unexplained eosinophilia. Conversely, more rarely extra-digestive features during follow-up in patients with EGID may lead to a diagnosis of an associated CTD. More research is needed to better understand the underlying pathophysiological processes leading to eosinophilic gastrointestinal infiltration in patients with CTD.
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Affiliation(s)
- Marie Lecouffe-Desprets
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Université Paris Descartes, National Referral Center for Rare Systemic and Autoimmune Diseases, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France; Hôtel-Dieu University Hospital, Department of Internal Medicine, 44000 Nantes, France
| | - Matthieu Groh
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Université Paris Descartes, National Referral Center for Rare Systemic and Autoimmune Diseases, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France
| | - Bruno Bour
- Le Mans General Hospital, Department of Gastroenterology, 72037 Le Mans, France
| | - Claire Le Jeunne
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Université Paris Descartes, National Referral Center for Rare Systemic and Autoimmune Diseases, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France
| | - Xavier Puéchal
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Université Paris Descartes, National Referral Center for Rare Systemic and Autoimmune Diseases, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France.
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Kumar B V, Martis JJS, Mathias SG, Kamath P, Shetty V. Rare case of ileal perforation. J Clin Diagn Res 2013; 7:1463-5. [PMID: 23998095 DOI: 10.7860/jcdr/2013/5227.3157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Accepted: 04/01/2013] [Indexed: 11/24/2022]
Abstract
Ileitis, or inflammation of the ileum, is often caused by Crohn's disease. However, ileitis may be caused by a wide variety of other diseases. These include infectious diseases, spondyloarthropathies, vasculitides, ischemia, neoplasms, medication-induced, eosinophilic enteritis, and others. Eosinophilic enteritis can present as abdominal pain, protein loosing enteropathy, ulcers, intestinal obstruction, intussusception and perforation.Bowel perforation is an uncommon presentation of eosinophilic enteritis. We report a rare case of ileal perforation due to eosinophilic enteritis in a 57 years old female.
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Affiliation(s)
- Vinod Kumar B
- Senior Resident, Department of General Surgery, Father Muller Medical College , Mangalore, Karnataka - 575002, India
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4
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Pearson EJ, Mennel R. Eosinophilic Small Bowel Enteritis in Response to Folinic Acid, Fluorouracil, and Oxaliplatin Chemotherapy. Proc (Bayl Univ Med Cent) 2013; 26:288-9. [DOI: 10.1080/08998280.2013.11928986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Bates AWH. Diagnosing eosinophilic colitis: histopathological pattern or nosological entity? SCIENTIFICA 2013; 2012:682576. [PMID: 24278727 PMCID: PMC3820477 DOI: 10.6064/2012/682576] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 05/06/2012] [Indexed: 06/02/2023]
Abstract
Reports of "eosinophilic colitis"-raised colonic mucosal eosinophil density in patients with lower gastrointestinal symptoms-have increased markedly over the last fifteen years, though it remains a rarity. There is no consensus over its diagnosis and management, and uncertainty is compounded by the use of the same term to describe an idiopathic increase in colonic eosinophils and an eosinophilic inflammatory reaction to known aetiological agents such as parasites or drugs. In patients with histologically proven colonic eosinophilia, it is important to seek out underlying causes and careful clinicopathological correlation is advised. Because of the variability of eosinophil density in the normal colon, it is recommended that histological reports of colonic eosinophilia include a quantitative morphometric assessment of eosinophil density, preferably across several sites. Few reported cases of "eosinophilic colitis" meet these criteria. As no correlation has been shown between colonic eosinophil density and symptoms in older children or adults, it is suggested that treatment should be directed towards alleviation of symptoms and response to treatment assessed clinically rather than by histological estimates of intramucosal eosinophils.
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Affiliation(s)
- Alan W. H. Bates
- Research Department of Pathology, University College London, London WC1E 6BT, UK
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Janssens P, Arnaud L, Galicier L, Mathian A, Hie M, Sene D, Haroche J, Veyssier-Belot C, Huynh-Charlier I, Grenier PA, Piette JC, Amoura Z. Lupus enteritis: from clinical findings to therapeutic management. Orphanet J Rare Dis 2013; 8:67. [PMID: 23642042 PMCID: PMC3651279 DOI: 10.1186/1750-1172-8-67] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 04/28/2013] [Indexed: 12/15/2022] Open
Abstract
Lupus enteritis is a rare and poorly understood cause of abdominal pain in patients with systemic lupus erythematosus (SLE). In this study, we report a series of 7 new patients with this rare condition who were referred to French tertiary care centers and perform a systematic literature review of SLE cases fulfilling the revised ACR criteria, with evidence for small bowel involvement, excluding those with infectious enteritis. We describe the characteristics of 143 previously published and 7 new cases. Clinical symptoms mostly included abdominal pain (97%), vomiting (42%), diarrhea (32%) and fever (20%). Laboratory features mostly reflected lupus activity: low complement levels (88%), anemia (52%), leukocytopenia or lymphocytopenia (40%) and thrombocytopenia (21%). Median CRP level was 2.0 mg/dL (range 0–8.2 mg/dL). Proteinuria was present in 47% of cases. Imaging studies revealed bowel wall edema (95%), ascites (78%), the characteristic target sign (71%), mesenteric abnormalities (71%) and bowel dilatation (24%). Only 9 patients (6%) had histologically confirmed vasculitis. All patients received corticosteroids as a first-line therapy, with additional immunosuppressants administered either from the initial episode or only in case of relapse (recurrence rate: 25%). Seven percent developed intestinal necrosis or perforation, yielding a mortality rate of 2.7%. Altogether, lupus enteritis is a poorly known cause of abdominal pain in SLE patients, with distinct clinical and therapeutic features. The disease may evolve to intestinal necrosis and perforation if untreated. Adding with this an excellent steroid responsiveness, timely diagnosis becomes primordial for the adequate management of this rare entity.
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Affiliation(s)
- Peter Janssens
- Department of internal medicine, French reference centre for Systemic Lupus Erythematosus, AP-HP, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
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7
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Luijten RK, Fritsch-Stork RD, Bijlsma JW, Derksen RH. The use of glucocorticoids in Systemic Lupus Erythematosus. After 60years still more an art than science. Autoimmun Rev 2013; 12:617-28. [DOI: 10.1016/j.autrev.2012.12.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 12/02/2012] [Indexed: 01/18/2023]
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Laxa BU, Bouchard A, De Petris G, Heigh R, Heppell J. Eosinophilic enteritis confined to an ileostomy site. Case Rep Gastroenterol 2011; 5:422-7. [PMID: 21960943 PMCID: PMC3180657 DOI: 10.1159/000329990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Eosinophilic enteritis is a rather rare condition that can manifest anywhere from esophagus to rectum. Its description in the literature is sparse, but associations have been made with collagen vascular disease, malignancy, food allergy, parasitic or viral infections, inflammatory bowel disease, and drug sensitivity. We present the case of a 41-year-old male diagnosed with ulcerative colitis who underwent proctocolectomy with ileal pouch anal anastomosis and loop ileostomy formation utilizing Seprafilm®, who later developed eosinophilic enteritis of the loop ileostomy site. This is the first report of eosinophilic enteritis and its possible link to the use of bioabsorbable adhesion barriers.
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Affiliation(s)
- Bernadette U Laxa
- Department of Surgery, Department of Surgery, Mayo Clinic Arizona, Phoenix, Ariz., USA
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Asadi Gharabaghi M, Abdollahi P, Kalany M, Sotoudeh M. Systemic lupus erythematosus presenting with eosinophilic enteritis: a case report. J Med Case Rep 2011; 5:235. [PMID: 21702974 PMCID: PMC3143100 DOI: 10.1186/1752-1947-5-235] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 06/25/2011] [Indexed: 12/23/2022] Open
Abstract
Introduction Systemic lupus erythematosus (SLE) is a multisystem disorder that may present with various symptoms. It may involve the gastrointestinal tract in a variety of ways; some of the most well-known ones are transaminitis, lupus mesenteric vasculitis, lupus enteritis and mesenteric vascular leakage. We describe a case of a patient with SLE who presented with a five-month history of diarrhea caused by eosinophilic enteritis. To the best of our knowledge, there are few cases reported in the literature of patients with SLE who initially present with chronic diarrhea due to eosinophilic enteritis. Case presentation A 38-year-old Persian Iranian woman was admitted with a five-month history of diarrhea and abdominal pain. A physical examination showed nothing abnormal. Initially, she had only lymphopenia and mild eosinophilia. No autoimmune or infectious etiology was detected to justify these abnormalities. A thorough evaluation was not helpful in finding the etiology, until she developed a scalp lesion similar to discoid lupus erythematosus. Computed tomography showed small bowel wall thickening. Briefly, she manifested full-blown SLE, and it was revealed that the diarrhea was caused by eosinophilic enteritis. Conclusion Considering SLE in a patient who presents with chronic diarrhea and lymphopenia may be helpful in earlier diagnosis and therapy. This is an original case report of interest to physicians who practice internal medicine, family medicine and gastroenterology.
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Affiliation(s)
- Mehrnaz Asadi Gharabaghi
- Department of General Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
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Hepburn IS, Sridhar S, Schade RR. Eosinophilic ascites, an unusual presentation of eosinophilic gastroenteritis: A case report and review. World J Gastrointest Pathophysiol 2010; 1:166-70. [PMID: 21607158 PMCID: PMC3097962 DOI: 10.4291/wjgp.v1.i5.166] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 09/28/2010] [Accepted: 10/05/2010] [Indexed: 02/06/2023] Open
Abstract
Eosinophilic ascites (EA) is a rare disorder of unknown etiology that has been reported in both adult and pediatric patients. It is a part of the syndrome of eosinophilic gastroenteritis, which is characterized by eosinophilic infiltration of any or all layers of the gut wall and may involve any segment of the gastrointestinal tract. Peripheral eosinophilia may or may not be present. We report a case of EA that developed post partum.
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Ju JH, Min JK, Jung CK, Oh SN, Kwok SK, Kang KY, Park KS, Ko HJ, Yoon CH, Park SH, Cho CS, Kim HY. Lupus mesenteric vasculitis can cause acute abdominal pain in patients with SLE. Nat Rev Rheumatol 2009; 5:273-81. [PMID: 19412194 DOI: 10.1038/nrrheum.2009.53] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Lupus mesenteric vasculitis (LMV) is a unique clinical entity found in patients who present with gastrointestinal manifestations of systemic lupus erythematosus, and is the main cause of acute abdominal pain in these patients. LMV usually presents as acute abdominal pain with sudden onset, severe intensity and diffuse localization. Other causes of abdominal pain, such as acute gastroenteritis, peptic ulcers, acute pancreatitis, peritonitis, and other reasons for abdominal surgery should be ruled out. Prompt and accurate diagnosis of LMV is critical to ensure implementation of appropriate immunosuppressive therapy and avoidance of unnecessary surgical intervention. The pathology of LMV comprises immune-complex deposition and complement activation, with subsequent submucosal edema, leukocytoclastic vasculitis and thrombus formation; most of these changes are confined to small mesenteric vessels. Abdominal CT is the most useful tool for diagnosing LMV, which is characterized by the presence of target signs, comb signs, and other associated findings. The presence of autoantibodies against phospholipids and endothelial cells might provide information about the likelihood of recurrence of LMV. Immediate, high-dose, intravenous steroid therapy can lead to a favorable outcome and prevent serious complications such as bowel ischemia, necrosis and perforation.
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Affiliation(s)
- Ji Hyeon Ju
- Rheumatology Division, College of Medicine, Catholic University of Korea, Seocho-Gu, Seoul, South Korea
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12
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Jaimes-Hernandez J, Aranda-Peirera P, Melendez-Mercado CI. Eosinophilic enteritis in association with systemic lupus erythematosus. Lupus 2009; 18:452-6. [PMID: 19318400 DOI: 10.1177/0961203308097573] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Eosinophilic gastroenteritis (EGE) is an uncommon disease and has rarely been reported in association with connective tissue diseases as systemic lupus erythematosus. We report a 36-year-old woman who developed recurrent episodes of abdominal pain, nausea, vomiting and melena. Complete blood counts showed elevated eosinophil counts. Ultrasound and CT-scan images studies were significant for bowel wall thickening and ascites. The patient underwent an exploratory laparotomy with a mesenteric biopsy and appendectomy that showed eosinophil infiltration in the muscularis propria, establishing the diagnosis of EGE. The patient developed pleural effusions, with laboratory studies showing haemolytic anaemia, thrombocytopenia, positive antinuclear antibody and anticardiolipin antibodies. The patient was treated with high-dose systemic corticosteroid therapy, with successful resolution of symptoms. Three months later, she developed a new episode of abdominal pain defined as intestinal pseudo-obstruction that was resolved without complications.
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Affiliation(s)
- J Jaimes-Hernandez
- Centro Médico ISSEMYM - División de Medicina Interna, Departamento de Reumatología, San Jerónicmo Chicahualco Metepec Estado de México, Mexico.
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Aslanidis S, Pyrpasopoulou A, Soufleris K, Kazantzidou E, Douma S. Eosinophilic enteritis with ascites in a patient with overlap syndrome. Case Rep Med 2009; 2009:734206. [PMID: 19710933 PMCID: PMC2729448 DOI: 10.1155/2009/734206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Accepted: 04/30/2009] [Indexed: 12/24/2022] Open
Abstract
Gastrointestinal involvement is frequent in patients with systemic lupus erythematosus (SLE). Eosinophilic gastroenteritis, however, has only rarely been described in rheumatological conditions, despite its reported connection to autoimmune diseases, such as hypereosinophilic syndrome, vasculitides, and systemic mastoidosis. It presents typically with abdominal pain and diarrhea and is only exceptionally associated with ascites. Diagnosis can be problematic, as several other clinical conditions (malignancies, infection/tuberculosis, and inflammatory bowel diseases) have to be ruled out. It is basically a nonsurgical disease, with excellent recovery on conservative treatment. We report the rare case of a young woman with overlap syndrome who presented with abdominal pain and ascites. The diagnosis of eosinophilic enteritis was made based on clinical, radiological, and laboratory criteria. The patient was treated with corticosteroids with excellent response.
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Affiliation(s)
- Spyros Aslanidis
- 12nd Propedeutic Department of Internal Medicine, Hippokration General Hospital, 54643 Thessaloniki, Greece
- *Spyros Aslanidis:
| | - Athina Pyrpasopoulou
- 12nd Propedeutic Department of Internal Medicine, Hippokration General Hospital, 54643 Thessaloniki, Greece
| | - Kostas Soufleris
- 12nd Propedeutic Department of Internal Medicine, Hippokration General Hospital, 54643 Thessaloniki, Greece
| | - Eirini Kazantzidou
- 2Radiology Department, Hippokration General Hospital, 54643 Thessaloniki, Greece
| | - Stella Douma
- 12nd Propedeutic Department of Internal Medicine, Hippokration General Hospital, 54643 Thessaloniki, Greece
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Asherson RA, Giampaolo D, Strimling M. A case of adult-onset Satoyoshi syndrome with gastric ulceration and eosinophilic enteritis. ACTA ACUST UNITED AC 2008; 4:439-44. [PMID: 18607399 DOI: 10.1038/ncprheum0839] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Accepted: 05/01/2008] [Indexed: 11/09/2022]
Abstract
BACKGROUND The patient was misdiagnosed as having Sjögren's syndrome (on the basis of a lower-limb rash and dry eyes and mouth) in 1999, and then as having systemic lupus erythematosus (on the basis of hair loss and a high antinuclear antibody titer) in 2005. Total alopecia, muscular spasms and diarrhea developed over the following 2 years, and the patient experienced gastric ulceration in 2006. A rheumatologic opinion was sought in 2007. INVESTIGATIONS Physical examination, CBC, glucose tolerance test, iron studies, HLA typing, immunological investigations and complete gastrointestinal investigations, including gastroscopy, colonoscopy and small bowel biopsy. DIAGNOSIS Satoyoshi syndrome with autoimmune features (high levels of antinuclear antibody and antibodies to thyroid tissue) and malabsorption due to eosinophilic enteritis. This patient is only the fifth adult in the world reported to have Satoyoshi syndrome, and the first-reported adult case from South Africa. MANAGEMENT The patient had only a transitory response to glucocorticoid treatment. Complete amelioration of symptoms resulted on two occasions when treated with intravenous immunoglobulin; however, the remissions only lasted for 6-8 weeks. More-intensive immunosuppression with azathioprine is currently being attempted.
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Affiliation(s)
- Ronald A Asherson
- Division of Immunology, School of Pathology, University of Witwatersrand, and Netcare Rosebank Hospital, Johannesburg, South Africa
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Abstract
Eosinophilic gastroenteritis is an infrequently diagnosed condition that is characterized by prominent eosinophilic infiltration of the stomach or small intestine, generally localized to one level of the intestinal wall; the variable organ locus and wall depth produce heterogeneous clinical presentations. A strong association with atopy is present in most cases, supported by circumstantial evidence and the demonstration of Th-2 proinflammatory cytokine profiles in animal studies. A high degree of suspicion is required to establish the diagnosis, which must be based on intense gastrointestinal eosinophilia. Management is directed toward removal of offending allergens and use of anti-inflammatory agents. Novel and emerging treatments on the horizon are biologic therapies and selective anti-eosinophil agents.
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Talley NJ. Gut eosinophilia in food allergy and systemic and autoimmune diseases. Gastroenterol Clin North Am 2008; 37:307-32, v. [PMID: 18499022 DOI: 10.1016/j.gtc.2008.02.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Eosinophilic gastroenteritis is a rare disease characterized by striking tissue eosinophilia in any layer of the gut wall; however, many diseases can cause increased gut eosinophilia. Allergic reactions to food are an important cause of gut eosinophilia. Not all adverse reactions to food are IgE mediated, and most cases of IgE-mediated food allergy do not have eosinophilic gastroenteritis. Parasitic, bacterial, and viral pathogens as well as certain systemic diseases such as vasculitis can cause gut eosinophilia. These heterogeneous conditions are reviewed in this article.
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Affiliation(s)
- Nicholas J Talley
- Division of Gastroenterology and Hepatology, Mayo Clinic Campus, Mayo Clinic, Jacksonville, FL 32224, USA.
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Abstract
Although we know that eosinophils reside in the normal gastrointestinal tract and increase during inflammatory states, their exact role in gut homeostasis and in the pathogenesis of inflammatory processes is not certain. An increasing number of clinical reports suggest that eosinophils participate in the pathogenesis of mucosal inflammation, and emerging literature is beginning to define these mechanisms. For example, homing of eosinophils to the gastrointestinal tract is better understood with respect to the roles of specific eosinophilic attractants, such as the eotaxins and interleukin-5. As mechanisms of eosinophil recruitment, activation, and functional responses are further elucidated, novel targets for treatment strategies in specific diseases will likely follow. We review recent developments in eosinophil immunobiology as they relate to gastrointestinal inflammation and provide an update on clinical aspects of eosinophilic esophagitis as they relate to eosoinophilic diseases of the gastrointestinal tract.
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Affiliation(s)
- Esi S N Lamousé-Smith
- Children's Hospital Boston, 300 Longwood Avenue, Hunnewell Ground Floor, Boston, MA 02115, USA
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