Eosinophilic Gastroenteritis Due to Egg Allergy Presenting as Acute Pancreatitis

Abstract

We describe a case of a 25-year-old female with newly diagnosed egg allergy, presenting with both peripheral and duodenal eosinophilia suspicious for eosinophilic gastroenteritis (EG). The EG was severe enough to have likely caused acute pancreatitis. Cessation of all egg products lead to resolution of all symptoms. This represents the first report of EG manifesting as pancreatitis due to egg ingestion.

Food-Induced Acute Pancreatitis

“…The association of EG with pancreatitis is also well reported in the literature and the major cause of EG is food allergy [23, 24, 48]. Numerous case reports indicate that EG can occur due to cow’s milk [23] and egg allergy, [24] and the severe EG symptoms may exacerbate acute pancreatitis.…”

“…The food allergy is mostly associated with an increase in Th2 cytokine, eosinophils and mast cells in response to allergens [33–36]. Food allergy has been reported in several allergic diseases including asthma [33–35], allergic rhinitis [37, 38], gastrointestinal disorders such as eosinophilic gastroenteritis [2, 39] and pancreatitis [23, 24]. Herein, we summarized the current understanding and available pieces of evidence about the development of eosinophilic gastroenteritis dependent and independent pancreatitis.…”

“…Several case reports of acute pancreatitis, provoked by food allergies to mustard [22], milk [13, 23], egg [24], bananas [10], fish [25] and kiwi fruits [26] in human have been published in the literature. Chronic pancreatitis persisting for as long as 8 to 10 years due to consumption of different types of food such as beef, milk, potato, fish, and eggs have also been reported [12].…”

“…Numerous case reports indicate that EG can occur due to cow’s milk [23] and egg allergy, [24] and the severe EG symptoms may exacerbate acute pancreatitis. Suzuki et al [23] reported a case of milk allergy associated pancreatitis, which rapidly improved after withdrawing the milk from diet and corticosteroids treatment.…”

“…Unfortunately, in the current scenario, the prevalence of food-induced acute or chronic pancreatitis is still not well reported. Since 1933, food-induced allergy has been known to be a cause of acute pancreatitis in dogs [21]; furthermore, several cases of acute pancreatitis in human caused by allergy to mustard [22], milk [13, 23], cod roe [14], egg [24], bananas [10], fish [25], and kiwi fruits [26] have been reported in literature. Several studies indicate that a high dietary glycemic load [27], fat, meat, egg etc.…”