A boy, aged 17 years, was admitted again due to abdominal pain, diarrhea, and eosinophilia for 3 years, which worsened for 3 days. Three years ago, the boy suffered from abdominal pain and diarrhea after eating yogurt; color Doppler ultrasound showed a large amount of peritoneal effusion, and routine blood test, bone marrow cell morphology, and ascites histological examination showed a large number of eosinophils. Three days ago, he was admitted again due to abdominal pain and diarrhea. The gastrointestinal endoscopy showed eosinophil infiltration in the angle of stomach. The boy was diagnosed with eosinophilic gastrointestinal disease (eosinophilic gastroenteritis). He was improved after the treatment with glucocorticoids and dietary avoidance, and no recurrence was observed during the one-year follow-up. It is concluded that for children who attend the hospital due to gastrointestinal symptoms such as abdominal pain and diarrhea, if there is an increase in peripheral blood eosinophils, it is necessary to consider the possibility of eosinophilic gastrointestinal disease, and eosinophil infiltration and abnormal eosinophil count in gastrointestinal tissue based on endoscopic biopsy may be the key to diagnosis. [Citation:Chinese Journal of Contemporary Pediatrics, 2021, 23(11): 1169-1173]
Key words
Osinophilic gastrointestinal disease /
Eosinophilic gastroenteritis /
Peritoneal effusion /
Eosinophilia /
Child
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
1 Choi B, Kim B. Prevalence and risk factors of intestinal parasite infection among schoolchildren in the peripheral highland regions of Huanuco, Peru[J]. Osong Public Health Res Perspect, 2017, 8(5): 302-307. PMID: 29164041. PMCID: PMC5678195. DOI: 10.24171/j.phrp.2017.8.5.03.
2 Licari A, Votto M, D'Auria E, et al. Eosinophilic gastrointestinal diseases in children: a practical review[J]. Curr Pediatr Rev, 2020, 16(2): 106-114. PMID: 31642786. DOI: 10.2174/1573396315666191022154432.
3 林燕凤, 张英秀, 付朝丽, 等. 2018年嗜酸性肉芽肿性多血管炎诊治规范专家共识解读[J]. 中国实用内科杂志, 2019, 39(5): 437-439. DOI: 10.19538/j.nk2019050110.
4 Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia[J]. Blood, 2016, 127(20): 2391-2405. PMID: 27069254. DOI: 10.1182/blood-2016-03-643544.
5 Pesek RD, Reed CC, Muir AB, et al. Increasing rates of diagnosis, substantial co-occurrence, and variable treatment patterns of eosinophilic gastritis, gastroenteritis, and colitis based on 10-year data across a multicenter consortium[J]. Am J Gastroenterol, 2019, 114(6): 984-994. PMID: 31008735. PMCID: PMC6554065. DOI: 10.14309/ajg.0000000000000228.
6 Pesek RD, Rothenberg ME. Eosinophilic gastrointestinal disease below the belt[J]. J Allergy Clin Immunol, 2020, 145(1): 87-89.e1. PMID: 31669097. PMCID: PMC8056972. DOI: 10.1016/j.jaci.2019.10.013.
7 Alexander ES, Martin LJ, Collins MH, et al. Twin and family studies reveal strong environmental and weaker genetic cues explaining heritability of eosinophilic esophagitis[J]. J Allergy Clin Immunol, 2014, 134(5): 1084-1092.e1. PMID: 25258143. PMCID: PMC4253562. DOI: 10.1016/j.jaci.2014.07.021.
8 Allen-Brady K, Firszt R, Fang JC, et al. Population-based familial aggregation of eosinophilic esophagitis suggests a genetic contribution[J]. J Allergy Clin Immunol, 2017, 140(4): 1138-1143. PMID: 28192145. DOI: 10.1016/j.jaci.2016.12.979.
9 顾伟, 陈敏, 焦建明. 父子同患嗜酸细胞性胃肠炎[J]. 中华医学遗传学杂志, 2005, 22(1): 48. DOI: 10.3760/j.issn:1003-9406.2005.01.047.
10 Klein NC, Hargrove RL, Sleisenger MH, et al. Eosinophilic gastroenteritis[J]. Medicine(Baltimore), 1970, 49(4): 299-319. PMID: 5426746. DOI: 10.1097/00005792-197007000-00003.
11 Lucendo AJ, Molina-Infante J, Arias á, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults[J]. United European Gastroenterol J, 2017, 5(3): 335-358. PMID: 28507746. PMCID: PMC5415218. DOI: 10.1177/2050640616689525.
12 Sonnenberg A, Turner KO, Singhal A, et al. Prevalence and concordant occurrence of esophageal, gastric, duodenal, and colonic eosinophilia[J]. Dis Esophagus, 2020, 33(10): doaa064. PMID: 32666091. DOI: 10.1093/dote/doaa064.
13 Pesek RD, Reed CC, Collins MH, et al. Association between endoscopic and histologic findings in a multicenter retrospective cohort of patients with non-esophageal eosinophilic gastrointestinal disorders[J]. Dig Dis Sci, 2020, 65(7): 2024-2035. PMID: 31773359. PMCID: PMC7315780. DOI: 10.1007/s10620-019-05961-4.
14 Laserna-Mendieta EJ, Casabona S, Guagnozzi D, et al. Efficacy of proton pump inhibitor therapy for eosinophilic oesophagitis in 630 patients: results from the EoE connect registry[J]. Aliment Pharmacol Ther, 2020, 52(5): 798-807. PMID: 32677040. DOI: 10.1111/apt.15957.
15 Pesek RD, Gupta SK. Future therapies for eosinophilic gastrointestinal disorders[J]. Ann Allergy Asthma Immunol, 2020, 124(3): 219-226. PMID: 31778820. DOI: 10.1016/j.anai.2019.11.018.
PDF(917 KB)
