Causes of eosinophilic ascites – A systematic review

Abstract

Background. In the last years an uprising interest for a relatively unknown entity, eosinophilic ascites (EA), has been recorded. Our aim is to investigate the potential causes of EA development, as well as clinical, laboratory, endoscopic and radiologic features, management and outcome in these patients. Methods. The following research was performed on PubMed (MEDLINE) database using the medical subject headings [Mesh] terms “Ascites” AND “Eosinophils”. Results. A total of 284 results, dating from 1962 onwards, were found and abstracts were examined. 131 papers were excluded and the remaining 153 publications, consisting in case reports and series of cases, were analyzed. From 171 patients with EA, 127 subjects (74%) had EGE, 17 (10%) parasitic and fungal infections, 11(7%) Hypereosinophilic syndrome and 16 patients (9%) less common diseases (eosinophilic pancreatitis, chronic eosinophilic leukemia, myelofibrosis, T-cell lymphoma, Churg Strauss Syndrome, Systemic lupus erythematosus, Familial paroxysmal polyserositis and Ménétrier’s disease). High eosinophil blood count and IgE levels as well as gastrointestinal symptoms are frequent. The diagnosis is based on ascitic fluid analysis, imaging and endoscopic biopsies. Therapy with corticosteroids results in resolution of eosinophilic ascites in almost all patients. Conclusion. In most cases, in the absence of allergy, parasitic infections, malignancy, hematological disorders, peritoneal tuberculosis, inflammatory bowel disease or autoimmune disease, EA develops as a manifestation of eosinophilic gastroenteritis.

Eosinophilic peritonitis and nephrotic syndrome in Kimura’s disease: a case report and literature review

“…However, there is currently no report of Kimura's disease with eosinophilic peritonitis among general population. Therapy with corticosteroids results in resolution in almost all patients with eosinophilic ascites [1]. In this case, eosinophil counts in ascites correlated with peripheral blood eosinophil counts, both decreased to normal after receiving corticosteroids therapy, similar to previous studies [7].…”

“…Eosinophilic peritonitis is a relatively rare entity defined as the presence of > 100 eosinophils/mm 3 , or > 10% eosinophils of the total non-erythrocyte count [7]. A recent systematic review reported in patients with eosinophilic peritonitis, 74% had eosinophilic gastroenteritis, 10% parasitic and fungal infections, 7% hypereosinophilic syndrome and 9% patients with less common diseases (eosinophilic pancreatitis, chronic eosinophilic leukemia, myelofibrosis, T-cell lymphoma, Churg Strauss syndrome, systemic lupus erythematosus, familial paroxysmal polyserositis and Ménétrier's disease) [1][2][3]. However, there is currently no report of Kimura's disease with eosinophilic peritonitis among general population.…”

“…Eosinophilic peritonitis is a relatively rare entity. The etiology of eosinophilic peritonitis is multifactorial, mostly being reported in patients with eosinophilic gastroenteritis, parasitic and fungal infections, hypereosinophilic syndrome and less common diseases including malignancy, hematological disorders, inflammatory bowel disease, autoimmune disease and peritoneal dialysis [1][2][3]. Kimura's disease is a rare chronic inflammatory disorder of unknown etiology, characterized by subcutaneous nodules mainly in the head and neck region, regional lymphadenopathy and occasional involvement of the major salivary glands and kidney.…”

A Challenging Case of Recurrent Eosinophilic Peritonitis

“…EP has been reported in patients with EGE, hyper-eosinophilic syndrome (HES), and parasitic infections [2]. It is characterized by the presence of >100 eosinophils/µlL or eosinophils comprising of >10% of the non-erythrocyte count of the ascitic fluid [3].…”

Eosinophilic pancreatitis versus pancreatitis associated with eosinophilic gastroenteritis – a systematic review regarding clinical features and diagnosis

“…In 8 patients the pain started 3 months or more before the moment of diagnosis. Some of them also had eosinophilic ascites [15] as a sign of gastroenteritis subserosal layer involvement (8/20).…”