Eosinophilic Ascites and Duodenal Obstruction in a Patient with Liver Cirrhosis

Maleki, Nasrollah; Hormozi, Mohammadreza Kalantar; Bahtouee, Mehrzad; Tavosi, Zahra; Pour, Hamidreza Mosallai; Kolaii, Seiiedeh Samaneh Taghiyan Jamaleddin

doi:10.1155/2014/928496

Cited by 3 publications

(5 citation statements)

References 19 publications

(43 reference statements)

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“…The biopsies of the duodenal bulb and gastric antrum noted moderate to marked lymphocytic infiltrates containing eosinophils. So, after careful investigation, the cause of abdominal pain, diarrhoea, nausea, vomiting and EA in our patient pointed to EG, which was supported further by the biopsy and a rapid clinical response to the steroid therapy 7 9 10…”

Section: Discussionsupporting

confidence: 59%

“…Most affected individuals have a history of allergies, with some exhibiting eosinophilia and elevated serum IgE levels 5. In 1970, Klein et al classified the disease according to the anatomic location of eosinophilic infiltration: the mucosal, muscularis and subserosal layers, once they noticed that the EG symptoms often differ depending on the location of eosinophil infiltration 2 6 7. In fact, when the mucosa is in the primary inflammatory location, stomach ache, diarrhoea and/or weight loss are often noted.…”

Section: Discussionmentioning

confidence: 99%

“…If the muscular layer is involved, nausea, vomiting and/or stomach ache may be the symptoms 1. EA is common when the serosa is involved, and is probably the most unusual and rare presentation of EG 4 7…”

Section: Discussionmentioning

confidence: 99%

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A 22-year-old male patient with ascites

et al. 2015

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A 22-year-old male patient presented with a 3-day history of abdominal pain, diarrhoea, nausea and vomiting. He reported abdominal distention of a couple of weeks' duration. He had been hospitalised 7 months earlier, owing to the same symptoms, however, the cause was never clarified. Initial examination showed abdominal distention and blood tests indicated eosinophilia. An abdominal CT scan showed mild ascites and a diffuse thickening of the small intestinal loops, and a cystic formation 3 cm in diameter on the liver. The differential diagnosis included parasite infection and eosinophilic gastroenteritis. Liver MRI revealed a simple biliary cyst. Microbiological tests, stool and blood cultures as well as stool examination for parasites were negative. The diagnostic paracentesis revealed eosinophilic ascites. An endoscopy was performed and histopathology revealed presence of moderate to marked lymphoplasmacytic infiltrate containing eosinophils, compatible with eosinophilic gastroenteritis. The patient responded well to the initiation of corticosteroids.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

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A 22-year-old male patient with ascites

et al. 2015

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“…In addition to the symptoms described above, 29 subjects associated less frequent features like constipation (6) [13,[22][23][24][25][26], bloating (1) [27], skin rash (4) [27][28][29][30], fever (3) [31][32][33], edema (2) [34][35], malabsorption (1) [36], melena (1) [37], even signs of pyloric stenosis (3) [38][39][40], intestinal occlusion or subocclusion(6) [41][42][43][44][45][46], peritonitis secondary to appendicitis (1) [47] and DVT in one patient with acute pancreatitis [48].…”

Section: Eosinophilic Gastroenteritis (Ege)mentioning

confidence: 99%

Causes of eosinophilic ascites – A systematic review

Pinte

Băicuș

2019

Romanian Journal of Internal Medicine

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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.

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“…Patients who are symptomatic or have evidence of malabsorption may be treated with systemic glucocorticoids. [10] The treatment with steroids shows an improvement in up to 90% of cases; however, the duration is not specified, and relapse is not uncommon; hence, treatment tends to prolonged. There is no consensus about the optimal type or dose of steroid; however, budesonide has the advantage of a local effect and a first step metabolism which entails less risk for adrenal suppression; the oral prednisolone dose most frequently administered is 40 mg/day for 7-14 days, followed by a progressive dose reduction.…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic peritonitis in a patient with liver cirrhosis: A case report

Pang

Fang

Zhi

et al. 2019

CRCP

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Eosinophilic gastroenteritis (EG) is a gastrointestinal disease characterized by abnormal infiltration of eosinophilic cells in the gastrointestinal tract, excluding known causes of eosinophilia. Eosinophilic peritonitis (EP) is rare and is considered by most scholars to be a systemic or local allergy to exogenous or endogenous allergens. It is a clinical manifestation of eosinophilic gastroenteritis involving the serosal layer. Hereby, we report a case of EP in a patient with liver cirrhosis. A 32-year-old man was admitted to our hospital for intermittent fatigue, abdominal distension and abdominal pain. On account of clinical feature and pathological results of peritoneal puncture biopsy, excluding other causes of peripheral eosinophilia, the diagnosis of EP with hepatic cirrhosis was established. The possibility of EP should be paid great attention to patients with cirrhosis with peritonitis. Gastrointestinal endoscope biopsy, laparoscopy or peritoneal puncture biopsy are conducive to the diagnosis and differential diagnosis. Therefore, once the disease is suspected, gastrointestinal endoscope biopsy should be performed actively, and multiple pathological samples should be taken to contribute to diagnosis and treatment. Laparoscopy or peritoneal puncture biopsy is of vital significance for definitive diagnosis.

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Eosinophilic Ascites and Duodenal Obstruction in a Patient with Liver Cirrhosis

Cited by 3 publications

References 19 publications

A 22-year-old male patient with ascites

A 22-year-old male patient with ascites

Causes of eosinophilic ascites – A systematic review

Eosinophilic peritonitis in a patient with liver cirrhosis: A case report

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