Eosinophilic Colitis: University of Minnesota Experience and Literature Review

“…Reports of imaging in EC describe unusual presentations, including a contrast enema demonstrating colocolonic intussusception [6], ileal wall thickening, mesenteric lymphadenopathy and a radiograph of cecal volvulus complicating EC [4]. Reported CT findings in adults include circumferential colonic wall thickening and ascites [11, 16], long-segment thickening from the ascending to the descending colon [17] and mucosal fold thickening and the “araneid-limb-like” sign in the ascending and transverse colon [12]. In addition, colonic inflammation has been noted as a feature of other eosinophilic gastrointestinal diseases.…”

Section: Discussionmentioning

confidence: 99%

CT imaging features of eosinophilic colitis in children

et al. 2013

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Background Eosinophilic colitis (EC) is a gastrointestinal disease of undetermined etiology whose clinical features overlap with those of the inflammatory bowel diseases. To the best of our knowledge, the CT imaging features of EC have not been described in children. Objective To report and analyze the clinical, imaging and histological findings in seven children with EC. Materials and methods Children with EC were identified in a pediatric pathology database, and those with CT imaging within 2 months of diagnosis were included, totaling seven children. Clinical, imaging and pathological features were reviewed and analyzed. Results The most common presenting symptoms were abdominal pain, bloody diarrhea and rectal bleeding. EC was characterized as a dense and predominantly eosinophilic inflammatory infiltrate in the lamina propria or epithelium without granulomas. CT scans were abnormal in six children (86%), demonstrating colonic wall thickening, predominantly cecal, in five (71%), mild to moderate terminal ileal thickening in two (29%), and pneumatosis in one (14%). Right colonic involvement was greater than terminal ileal involvement. Conclusion CT imaging findings in children with EC include right colonic wall thickening of variable extent downstream and absent or mild involvement of the terminal ileum. EC should be considered in the differential diagnosis in children presenting with abdominal pain and bloody diarrhea.

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“…7), eosinophilic cryptitis or crypt abscesses, crypts architecture impairment, increased intraepithelial eosinophils, and/or the presence of eosinophils in the muscularis mucosa and submucosa [54]. The histological criteria for diagnosing EC in adults include the presence of at least 100 eos/hpf in the cecum and ascending colon, 84 eos/hpf in the transverse and descending colon, and 64 eos/hpf in the rectosigmoid area [21].…”

Section: Eosinophilic Colitismentioning

confidence: 99%

Eosinophilic Gastrointestinal Diseases in Childhood

Koutri

Papadopoulou

2018

Ann Nutr Metab

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Eosinophilic gastrointestinal diseases (EGIDs) comprise a group of chronic, inflammatory diseases of the gastrointestinal (GI) tract, that are characterized, clinically, by symptoms related to the dysfunction of the involved segment(s) of the GI tract, and histologically, by dense eosinophilic inflammation, in the absence of an identifiable secondary cause. The group of EGIDs comprises eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE), and eosinophilic colitis (EC). EoE is the most common and the best described EGID compared to EG, EGE, and EC. The clinical presentation of the EGIDs differs depending on the location and the extent of the eosinophilic infiltration in the GI tract, as well as its depth through the bowel wall. In the absence of biological markers, the diagnosis is based on the combination of clinical symptoms with the histological features of EGIDs, after the exclusion of secondary causes of eosinophilic inflammation of the GI tract. Treatment is individualized and includes elimination diets (mainly empiric or elemental) and/or drugs, according to the involved GI segment: proton pump inhibitors or local steroids in EoE; local or oral systemic steroids in EG/EGE limited to the duodenum; oral systemic steroids in EGE with lower small intestine and/or colon involvement. In patients with EoE, maintenance treatment with lower doses may be considered following histological remission with the means of drugs. In patients treated with elimination diets, disease food triggers identified during food reintroduction need to be further eliminated. Esophageal stenosis despite medical treatment requires endoscopic dilation, while the use of thiopurines or anti-TNF drugs may be considered in refractory or steroid-dependent EGID (other than EoE). The aim of this review is to provide the available evidence on each of the above disorders, to aid clinicians to interpret the clinical manifestations and the laboratory findings and choose the best available treatment option.

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Eosinophilic Colitis: University of Minnesota Experience and Literature Review

Cited by 48 publications

References 42 publications

Clinico-pathological study of colonoscopic biopsies in patients with chronic diarrhea

Clinico-pathological study of colonoscopic biopsies in patients with chronic diarrhea

CT imaging features of eosinophilic colitis in children

Eosinophilic Gastrointestinal Diseases in Childhood

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