Eosinophilic Colitis

Background/Aims: The significance of the association between many gastrointestinal pathologies and autism is yet to be discovered. The aim of this report is to highlight an association between autism and microscopic eosinophilic colitis in 2 children. The possible mechanisms that may connect these two conditions are discussed. Methods and Results: A rare association between autism and microscopic eosinophilic colitis in 2 children is reported through retrospective chart review. Common causes of secondary eosinophilic colitis were excluded. Conclusion: This report suggests the possibility of either impaired intestinal barrier function or an aberrant immune system that predisposes autistic children to sensitization to environmental antigens. Large controlled studies are needed to examine this hypothesis.

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“…EC can be primary or secondary – the result of a spectrum of conditions that elicit GI eosinophilia [4,5]. …”

Section: Discussionmentioning

confidence: 99%

Childhood Autism and Eosinophilic Colitis

Chen

Girgis²,

El‐Matary³

2010

Digestion

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“…Transmural disease, reported to a lesser extent, presents with colonic wall thickening and intestinal obstruction [3,56,57]. Patients with EC may also demonstrate perianal disease [58], visceral neuropathy, and chronic intestinal pseudo-obstruction [59], cecal volvulus [60], and appendicitis [61]. EC may have similar features to that of colon carcinoma on barium enema, and care must be taken with radiographic interpretation of this test, especially in the elderly population [62].…”

Section: Serosalmentioning

confidence: 99%

Eosinophilic Gastroenteritis and Colitis: a Comprehensive Review

Uppal

Kreiger

Kutsch

2015

Clinic Rev Allerg Immunol

151

117

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Eosinophilic gastrointestinal disorders, including eosinophilic esophagitis, gastroenteritis, and colitis, refer to a spectrum of clinical diseases that present with variable degrees of infiltration of the gastrointestinal tract by eosinophils in the absence of other known causes of tissue eosinophilia. Clinical symptoms and laboratory findings are usually non-specific and may or may not be accompanied by peripheral blood eosinophilia. The extent of eosinophilic infiltration of the gastrointestinal wall varies from mucosal to transmural and serosal involvement. Diagnosis requires presence of gastrointestinal symptoms, demonstration of gastrointestinal eosinophilia by biopsy, and exclusion of other known causes of tissue eosinophilia. Many studies have pointed toward the eosinophil as the major offender; however, the exact functional role of the eosinophil in the pathogenesis of eosinophilic gastrointestinal disorders remains unclear. The roles of T-helper-2 cytokines and other mediators, such as eotaxin-1 and interleukin-5, have gained significant importance in the pathobiology of eosinophilic gastrointestinal disorders. Current understanding of treatment is based on case reports and a few case series, as there is a lack of large prospective studies. Steroids are currently the mainstay of therapy, but the roles of other drugs such as leukotriene inhibitors, mast cell stabilizers, interleukin-5 inhibitors, and anti-immunoglobulin E, along with other targets in the immune pathway, are currently being explored.

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“…Eosinophilic predominant ascites (up to 95% eosinophils) is a manifestation of serosal involvement [Ong et al 2002;Kravis et al 1982]. EC can present acutely with abdominal symptoms such as cecal volvulus causing intestinal obstruction [Velchuru et al 2007], intussusception, and perforation (Table 2).…”

Section: Eosinophilic Esophagitismentioning

confidence: 99%

“…Colon eosinophilic infiltrate can also occur secondarily to several conditions such as parasitic helminthic infections with Strongyloides stercoralis, Enterobius vermicularis, and Trichuris trichiura (whipworm) [Chandrasekhara et al 2007;Macedo and MacCarty, 2000;Alsamman et al 1999;Cacopardo et al 1997] and secondary to drugs such as clozapine [Ong et al 2002], carbamazepine [Velchuru et al 2007], rifampicin, gold [Lange et al 1994;Martin et al 1981], and naproxen [Jimenez-Saenz et al 2006;Bridges et al 1990]. Liver transplant recipients maintained on tacrolimus as an immunosuppressive agent, are at risk of developing colonic eosinophilia; symptomatic improvement occurs when the immunosuppression is reduced [Saeed et al 2006].…”

Section: Eosinophilic Esophagitismentioning

confidence: 99%

Eosinophilic colitis: epidemiology, clinical features, and current management

Alfadda

Storr

Shaffer

2010

Therap Adv Gastroenterol

122

137

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Primary eosinophilic gastrointestinal disorders (EGIDs) represent a spectrum of inflammatory gastrointestinal disorders in which eosinophils infiltrate the gut in the absence of known causes for such tissue eosinophilia. EGIDs can be subgrouped as eosinophilic esophagitis (EE), eosinophilic gastroenteritis (EG), and eosinophilic colitis (EC). The least frequent manifestation of EGIDs is EC. EC is a heterogeneous entity with a bimodal age distribution, presenting with either an acute self-limited bloody diarrhea in otherwise healthy infants or as a more chronic relapsing colitis in young adults. The pathophysiology of primary EC appears related to altered hypersensitivity, principally as a food allergy in infants and T lymphocytemediated (i.e. non-IgE associated) in young adults. In adults, symptoms include diarrhea, abdominal pain, and weight loss. Endoscopic changes are generally modest, featuring edema and patchy granularity. Although standardized criteria are not yet established, the diagnosis of EC depends on histopathology that identifies an excess of eosinophils. Therapeutic approaches are based on case reports and small case series, as prospective randomized controlled trials are lacking. Eosinophilic colitis in infants is a rather benign, frequently food-related entity and dietary elimination of the aggressor often resolves the disorder within days. Adolescent or older patients require more aggressive medical management including: glucocorticoids, antihistamines, leukotriene receptors antagonists as well as novel approaches employing biologics that target interleukin-5 (IL-5) and IgE. This review article summarizes the current knowledge of EC, its epidemiology, clinical manifestations, diagnosis, and treatment.

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Eosinophilic Colitis

Cited by 32 publications

References 6 publications

Childhood Autism and Eosinophilic Colitis

Childhood Autism and Eosinophilic Colitis

Eosinophilic Gastroenteritis and Colitis: a Comprehensive Review

Eosinophilic colitis: epidemiology, clinical features, and current management

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