Gastroenterite eosinofílica: divertículo duodenal intraluminal como fator predisponente?

Lima, Jandira; Rebelo, Marta; Castellano, Amparo; Mota, Joana; Ruivo, Catarina; Dias, Patrícia; Vieira, José Gilberto H.; Silva, Mário J.; Costa, Nascimento

doi:10.1016/j.jpg.2012.04.002

Cited by 3 publications

(6 citation statements)

References 11 publications

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“…A Gastroenterite Eosinofílica pode ser dividida em três formas conforme sua apresentação histopatológica segundo a classificação de Klein, sendo a predominantemente mucosa (57,5% dos casos), predominantemente muscular (30% dos casos) ou predominantemente serosa (12,5% dos casos) (MORETTI et al, 2006;LIMA et al, 2012), sua clínica comumente se apresenta como dor abdominal, diarreia, vômitos, emagrecimento, anemia, ascite e obstrução intestinal. Quando se dividem os sintomas conforme a camada acometida é observada acometimento do tecido mucoso: náuseas, vomito, diarreia, dor abdominal, ulceração, perda de proteínas, síndrome de má-absorção, emagrecimento e anemia, sendo a mais comumente diagnosticada.…”

Section: Discussionunclassified

“…O diagnóstico de GE é realizado com uma alta suspeição clinica, demonstração histológica de infiltrado eosinofílico no TGI e afastamento de outras causas conhecidas para a eosinofilia periférica (SERNA HIGUERA et al, 2002), há de se observar que a distribuição irregular da doença, assim como a possível presença de formas sem infiltração da mucosa, podem gerar falsos negativos frequentes nas amostras de biópsia, acarretando possíveis subdiagnósticos, sendo recomendado múltiplas biopsias no esôfago, estômago e intestino, mesmo que a mucosa tenha um aspeto normal, para obtenção da confirmação diagnostica de gastroenterite eosinofílica (LIMA et al, 2012).…”

Section: Introductionunclassified

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Gastroenterite Eosinofílica Em Um Idoso: Relato De Caso

et al. 2018

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A Gastroenterite Eosinofílica (GE) é uma doença rara, crônica, de etiologia ainda desconhecida e com uma apresentação heterogênea, caracterizada por infiltração maciça de eosinófilos em, pelo menos, um dos segmentos do trato gastrointestinal. Seu quadro clinico é variável conforme o local e profundidade da infiltração, apresentando desde sintomas gastrointestinais comuns até doença oclusiva intestinal -o que torna a clínica inespecífica, exigindo alta suspeição, comprovação histológica e exclusão de várias patologias associadas a eosinofilia periférica para o fechamento do diagnóstico, sendo uma patologia possivelmente subdiagnósticada. Apresentamos o caso de um adulto com diarréia líquida e perda ponderal significativa, sem melhoras ao uso de medicamentos. Tratava-se de uma Gastroenterite Eosinofílica, patologia de exclusão, que respondeu ao uso de corticóide, estando assintomático até a descrição deste relato.Palavras chave: Diagnóstico; Eosinofilia; Gastroenterite; Trato Gastrointestinal. ABSTRACTEosinophilic Gastroenteritis in an elderly man: Case Report. Eosinophilic Gastroenteritis (GE) is a rare, chronic, disease of unknown etiology with a heterogeneous presentation, characterized by massive infiltration of eosinophils in at least one segment of the gastrointestinal tract. Its clinical condition varies according to the site and depth of the infiltration, ranging from common gastrointestinal symptoms to intestinal occlusive disease -which makes the clinic unspecific, requiring high suspicion, histological confirmation and exclusion of several pathologies associated with peripheral eosinophilia for the diagnosis closure, being a pathology possibly underdiagnosed. We present the case of an adult with liquid diarrhea and significant weight loss, with no improvement in medication use. It was an Eosinophilic Gastroenteritis, a pathology of exclusion, which responded to the use of corticosteroids, being asymptomatic up to the description of this report.

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Section: Discussionunclassified

Section: Introductionunclassified

Gastroenterite Eosinofílica Em Um Idoso: Relato De Caso

et al. 2018

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“…However, in both cases, there was no pathological description of the eosinophils count to confirm whether it is a normal or altered number for the duodenal region. ( 9 )…”

Section: Discussionmentioning

confidence: 99%

Esophageal eosinophilia in pediatric patients with cerebral palsy

Nápolis

Alves

Rezende

et al. 2015

Einstein (São Paulo)

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Objective:To describe the clinical picture, test results, and clinical evolution of patients with cerebral palsy associated with diagnosis of eosinophilic esophagitis, monitored at tertiary centre.Methods:Cross-sectional, retrospective and descriptive study that evaluated the medical records data of pediatric patients with diagnosis of cerebral palsy and eosinophilic esophagitis in a tertiary center of pediatric gastroenterology between August 2005 and August 2013.Results:Seven out of 131 patients with cerebral palsy had the diagnosis of eosinophilic esophagitis. The mean age at diagnosis of eosinophilic esophagitis was 52.3 months and the mean number of eosinophils in esophagus was 35 per high-power field. Symptoms more frequent were recurrent vomiting and disphagia. Endoscopic alterations found were mucosal thickening, vertical lines, mucosal opacificacion and white plaques.Conclusion:The frequency of eosinophilic esophagitis found was higher than in general pediatric population. The investigation of eosinophilic esophagitis should be done regularly in those patients, once this entity could overlap other gastrointestinal diseases.

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“…Food allergies or immune anomalies have been determined to be its main etiologies and are reported in 25%-75% patients [ 4 , 6 ]. Moreover, some studies reported eosinophilic gastroenteritis caused by medications such as gold salts, enalapril, azathioprine, co-trimoxazole, gemfibrozil and carbamazepine [ 3 , 4 , 8 - 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…This allows antigens to cross the mucosa, thus inducing degranulation of mast cells, which release chemotactic factors that recruit eosinophils. The gastrointestinal tract is thus susceptible to direct damage by eosinophils via the release of toxic proteins (major basic protein and eosinophil peroxidase) as well as indirect damage via leukotrienes, release of histamine and cytokines (IL-2, IL-3, IL-4, IL-5), tumor necrosis factor alpha (TNF-a), granulocyte-macrophage colony-stimulating factor (GM-CSF) and transforming growth factor beta (TGF-b) [ 4 , 8 , 11 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

Eosinophilic Gastroenteritis With Malabsorption, Acute Intestinal Obstruction, Ascites and Pleural Effusion: A Case Report and Review of Literature

Brasil¹

2013

Gastroenterology Research

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We report a case of a 49-year-old male patient with abdominal distension and diffuse stomach cramps associated with peripheral eosinophilia. Treatment for eosinophilic parasitosis was not effective. After a few weeks, the patient developed acute obstructive abdomen with ascites, which was atypically improved with the use of antispasmodics and analgesics. Upper digestive endoscopy, colonoscopy and histopathologic examination of the gastric and intestinal mucosa did not show any significant changes. Video laparoscopic biopsy of the mesenteric lymph node and peritoneum revealed a nonspecific chronic inflammatory process with intense diffuse tissue eosinophilia. Complementary tests revealed right-sided pleural effusion and increased serum immunoglobulin E levels, with altered D-xylose absorption test results. The patient was treated with a hypoallergenic diet and an oral corticosteroid; the symptoms resolved and the laboratory test results improved. Eosinophilic gastroenteritis is a rare inflammatory disease characterized by eosinophilic infiltration in the wall of the gastrointestinal tract. The clinical presentation varies according to the affected site and the depth and extent of digestive tract involvement. This case report, which presents the rare simultaneous involvement of the mucosal, muscular and serosal layers, aims to describe and discuss the clinical and therapeutic aspects of eosinophilic gastroenteritis as well as its progression.

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Gastroenterite eosinofílica: divertículo duodenal intraluminal como fator predisponente?

Cited by 3 publications

References 11 publications

Gastroenterite Eosinofílica Em Um Idoso: Relato De Caso

Gastroenterite Eosinofílica Em Um Idoso: Relato De Caso

Esophageal eosinophilia in pediatric patients with cerebral palsy

Eosinophilic Gastroenteritis With Malabsorption, Acute Intestinal Obstruction, Ascites and Pleural Effusion: A Case Report and Review of Literature

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