Eosinophilic Gastroenteritis Presenting As Unexplained Chronic Abdominal Pain

Gaballa, Salem; Hlaing, Kyaw M; Mahler, Nathan; Hargrove, Richard; Roberts, Marigny

doi:10.7759/cureus.8640

Cited by 2 publications

(3 citation statements)

References 12 publications

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“…While there is no consensus value for how many eosinophils per HPF are required to diagnose EGE, pathologists such as Dr. Collins at Cincinnati Children’s Hospital recommend using 30/HPF when evaluating the duodenum and 30/HPF in five samples when evaluating the stomach [ 10 ]. Others, such as Gaballa et al, use a cutoff of 20 eosinophils/HPF to diagnose EGE [ 1 , 6 , 8 , 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

March of the Eosinophils: A Case of Eosinophilic Gastroenteritis, Immune Thrombocytopenia, and Iron Deficiency Anemia

Singh¹,

Farooq²,

Mian³

et al. 2022

Cureus

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Eosinophilic gastrointestinal disorders (EGIDs) refer to eosinophilic infiltration of various sections of the gastrointestinal tract in the absence of secondary causes. Diagnosis of EGID requires histological evidence of eosinophilic infiltration of the GI tract. Here, we present a case of a young male with biopsy-proven eosinophilic gastroenteritis with a concomitant established diagnosis of immune thrombocytopenic purpura (ITP).Presently, EGIDs remain an underexplored clinical entity. While its pathophysiology is not fully understood at this time, TH2 mediated activation of B-cells and subsequent stimulation of eosinophils locally appears to be at play. This is in contrast to the TH1 predominant cytokine profile underlying ITP, which this patient also has. Treatment typically involves dietary modifications and glucocorticoids.

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Section: Discussionmentioning

confidence: 99%

March of the Eosinophils: A Case of Eosinophilic Gastroenteritis, Immune Thrombocytopenia, and Iron Deficiency Anemia

Singh¹,

Farooq²,

Mian³

et al. 2022

Cureus

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“…If symptoms are still present after withdrawal, prednisone 5-10 mg/d or budesonide 3-9 mg should be taken to sustain remission. The elimination diet is not studied in adults, and it is not known if it is as effective as in EE [46,47].…”

Section: • Treatmentmentioning

confidence: 99%

“…Eosinophilic count per high-power microscopy field (HPF) in different types of eosinophilic inflammation[45][46][47].…”

mentioning

confidence: 99%

Management of Adult Patients with Gastrointestinal Symptoms from Food Hypersensitivity—Narrative Review

Kanikowska

Janisz

Mańkowska-Wierzbicka

et al. 2022

JCM

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The incidence of food hypersensitivity has increased dramatically over the years not only among children but also in adults. Adult patients are usually less suspected of food hypersensitivity symptoms since food allergies are more typical for small children, with a tendency to outgrow the condition. The aim of this article is to increase awareness of hypersensitivity to food symptoms and their diagnosis and treatment possibilities among gastroenterologists and other health care professionals dealing with this type of patient. Symptoms of many gastrointestinal disorders, especially functional, may be driven by different types of mechanisms, and food intolerance or allergy should be considered as a potential cause. This article presents the current understanding of the epidemiology, diagnosis and treatment of immune- and non-immune-mediated food-induced diseases. Diagnosis of food hypersensitivity is based mainly on medical history, different types of sensitivity tests, e.g., hydrogen breath test, specific IgE (sIgE) serum concentration, tissue eosinophil count, skin tests and oral food challenges considered as a “gold standard” for food allergy. Elimination diet and pharmacologic treatment for allergy symptoms are first-line therapies. Eosinophilic gastrointestinal diseases are often caused by non-IgE-mediated food allergies, require endoscopic biopsy samples to confirm diagnosis and proper elimination diet often combined with steroids or proton pump inhibitor agents for treatment. Mast cell activation syndrome (MCAS) derives from pathologic reaction of mast cells with increased tryptase serum level as a marker. Symptoms may occur in the digestive, respiratory, skin, neurologic and cardiovascular system. Treatment is based on histamine type 1, type 2 (H1, H2) receptor antagonists and other mast cell stabilizing agents. Carbohydrate intolerances are the most common type of food hypersensitivity in adult patients, and an elimination diet is effective for reducing symptoms. Food additives hypersensitivity remains difficult to diagnose, but use of a diet low in chemical substances alleviates symptoms and helps to diagnose the triggering factors.

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Eosinophilic Gastroenteritis Presenting As Unexplained Chronic Abdominal Pain

Cited by 2 publications

References 12 publications

March of the Eosinophils: A Case of Eosinophilic Gastroenteritis, Immune Thrombocytopenia, and Iron Deficiency Anemia

March of the Eosinophils: A Case of Eosinophilic Gastroenteritis, Immune Thrombocytopenia, and Iron Deficiency Anemia

Management of Adult Patients with Gastrointestinal Symptoms from Food Hypersensitivity—Narrative Review

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