Eosinophilic Gastroenteritis in the Pediatric Patient

Kravis, Lillian P.; South, Mary Ann; Rosenlund, Mary Loretta

doi:10.1177/000992288202101202

Cited by 28 publications

(16 citation statements)

References 20 publications

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“…Transmural disease has been associated with bowel wall thickening on imaging studies, obstruction, volvulus [9], intussusceptions [10, 11], and even perforation [12, 13]. Serosal involvement is often distinguished by the presence of eosinophilic ascites (Figure 1) [14]. …”

Section: Clinical Presentationmentioning

confidence: 99%

Eosinophilic Colitis: University of Minnesota Experience and Literature Review

Gaertner

MacDonald

Kwaan

et al. 2011

Gastroenterology Research and Practice

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Eosinophilic colitis is a rare form of primary eosinophilic gastrointestinal disease that is poorly understood. Neonates and young adults are more frequently affected. Clinical presentation is highly variable depending on the depth of inflammatory response (mucosal, transmural, or serosal). The pathophysiology of eosinophilic colitis is unclear but is suspected to be related to a hypersensitivity reaction given its correlation with other atopic disorders and clinical response to corticosteroid therapy. Diagnosis is that of exclusion and differential diagnoses are many because colonic tissue eosinophilia may occur with other colitides (parasitic, drug-induced, inflammatory bowel disease, and various connective tissue disorders). Similar to other eosinophilic gastrointestinal disorders, steroid-based therapy and diet modification achieve very good and durable responses. In this paper, we present our experience with this rare pathology. Five patients (3 pediatric and 2 adults) presented with diarrhea and hematochezia. Mean age at presentation was 26 years. Mean duration of symptoms before pathologic diagnosis was 8 months. Mean eosinophil count per patient was 31 per high-power field. The pediatric patients responded very well to dietary modifications, with no recurrences. The adult patients were treated with steroids and did not respond. Overall mean followup was 22 (range, 2–48) months.

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Section: Clinical Presentationmentioning

confidence: 99%

Eosinophilic Colitis: University of Minnesota Experience and Literature Review

Gaertner

MacDonald

Kwaan

et al. 2011

Gastroenterology Research and Practice

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“…Those with transmural disease present with intestinal obstruction, volvulus [4], intussusception [5, 6] or perforation [7, 8]. Serosal involvement is generally associated with ascites [9], which can be eosinophilic [10]. Diagnosis is confounded by the fact that no standard exists for the normal quantity of colonic eosinophils.…”

Section: Introductionmentioning

confidence: 99%

“…Treatment for EC is oral corticosteroids. Although a series of reports present detailed radiological findings of EC in adults, imaging findings in children have not been described [4–10, 12]. Our objective was to review the clinical, imaging and pathological features in children with EC.…”

Section: Introductionmentioning

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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“…Finally, serosal involvement is distinguished by the presence of eosinophilic ascites, with up to 88% eosinophils seen on fluid analysis. 10 Accordingly, while mucosal EC results in diarrhea, 11 the transmural form has been associated with volvulus, 12 intussusception, 13,14 and even perforation, 15,16 and involvement of the intestinal serosa may manifest with ascites, 17 which was also illustrated by a case that we have encountered recently. The diagnosis of EGID is made from the presence of gastrointestinal symptoms, peripheral eosinophilia, endoscopic and histological findings, and eosinophilic ascites, with no well-defined causes of eosinophilia on thorough evaluation.…”

Section: Discussionmentioning

confidence: 83%

Eosinophilic colitis in 36 years old female: a case presentation with review of literature

et al. 2015

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<p class="abstract"><span lang="EN-US">Eosinophilic Colitis (EC) is a rare form of primary eosinophilic gastrointestinal disease with prevalence in neonates and young adults. EC condition is less understood as compared to the recognized eosinophilic esophagitis. Clinically EC presents as highly variable disease and it is based according to mucosal, transmural, or serosal predominance of inflammation. EC has a vast range of differential diagnosis because eosinophilia of colon occurs in many conditions like parasitic infection, Inflammatory Bowel Disease (IBD), drug-induced allergic reactions and various connective tissue disorders and so it require to rule out these causes by thorough searching for secondary causes which can be treated with antibiotics or dietary and drug elimination before we start the EC treatment. EC responds very well to steroids that may be spared by using antihistamines, leukotriene inhibitors and biologics. Here we present a case of EC in a 36 years old female with pain in abdomen and bloody diarrhoea.</span></p>

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Eosinophilic Gastroenteritis in the Pediatric Patient

Cited by 28 publications

References 20 publications

Eosinophilic Colitis: University of Minnesota Experience and Literature Review

Eosinophilic Colitis: University of Minnesota Experience and Literature Review

CT imaging features of eosinophilic colitis in children

Eosinophilic colitis in 36 years old female: a case presentation with review of literature

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