Freeman Hugh J
Department of Medicine, Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada.
Can J Gastroenterol. 2009 Sep;23(9):632-4. doi: 10.1155/2009/565293.
Eosinophilic gastroenteritis (EGE) is an eosinophil-predominant inflammatory process that may be detected in endoscopic gastric or intestinal biopsies. The long-term natural history and effects of EGE treatment are not known. A 44-year-old man with abdominal pain was treated with oral ketotifen and followed for more than 20 years. Ketotifen provided symptomatic benefit, with prompt clinical relapse if the drug was discontinued. However, despite the use of ketotifen, the endoscopic abnormalities persisted and appeared to progress. Gastric body and antral mucosal folds appeared thickened, erythematous and friable, with minimal erosive change. Later, even during long asymptomatic periods suggesting clinical 'remission', inflammatory polypoid change, previously described in children with EGE, developed with mucosal 'pock-marking' and apparent scarring. Ketotifen treatment does not appear to prohibit or reverse the inflammatory process in the gastric mucosa in EGE, although long-term effects of steroids may be avoided. In the future, treatment of EGE may involve monoclonal antibody agents that target the specific biological effects of the eosinophil, apparently central to this unusual inflammatory process.
嗜酸性粒细胞性胃肠炎（EGE）是一种以嗜酸性粒细胞为主的炎症过程，可在内镜下胃或肠道活检中检测到。EGE的长期自然病史和治疗效果尚不清楚。一名44岁腹痛男性接受口服酮替芬治疗并随访20多年。酮替芬有症状改善作用，但停药后临床迅速复发。然而，尽管使用了酮替芬，内镜异常仍持续存在且似乎有进展。胃体和胃窦黏膜皱襞增厚、红斑且脆弱，有轻微糜烂改变。后来，即使在提示临床“缓解”的长期无症状期，EGE患儿中先前描述的炎性息肉样改变也出现了，伴有黏膜“麻子样”改变和明显瘢痕形成。酮替芬治疗似乎不能阻止或逆转EGE胃黏膜中的炎症过程，尽管可能避免了类固醇的长期影响。未来，EGE的治疗可能涉及针对嗜酸性粒细胞特定生物学效应的单克隆抗体药物，这显然是这种不寻常炎症过程的核心。
