1st Division of Internal Medicine and Hepato-gastroenterology Unit, Medical School, University of Ioannina, GR 45110, Greece.
J Crohns Colitis. 2011 Jun;5(3):256-61. doi: 10.1016/j.crohns.2011.02.009. Epub 2011 Mar 10.
Eosinophilic colitis is an idiopathic inflammation of the alimentary canal and is characterized by infiltration of the intestinal wall by eosinophils, massive submucosal edema, and peripheral eosinophilia. However, the presence of eosinophils in a colon biopsy requires thorough searching for secondary causes and eosinophilic colitis remains a diagnosis of exclusion. A 67-year-old male patient underwent a diagnostic ileocolonoscopy because of recurrent episodes of diarrhea for the last six months. Colonoscopy revealed a normal terminal ileum while in the entire colon an erythematous mucosa with very slight edema on a continuous pattern that was more pronounced in the left colon. The laboratory workup demonstrated eosinophils slightly elevated, biochemical tests were unremarkable and further clinical and laboratory workup was unremarkable. Histology showed overlapping findings of eosinophilic colitis and Crohn's colitis. Patient started on mesalazine 2.4 with very good results. A review of the literature shows that the spectrum of eosinophil involvement in inflammatory bowel disease as well as in eosinophilic colitis is largely varying, including also some exceptional cases that parallel the case described herein.
嗜酸性结肠炎是一种特发性消化道炎症，其特征为肠壁浸润嗜酸粒细胞、大量黏膜下水肿和外周嗜酸粒细胞增多。然而，结肠活检中嗜酸粒细胞的存在需要彻底寻找继发性原因，并且嗜酸性结肠炎仍然是排除性诊断。一位 67 岁男性患者因最近六个月反复发作性腹泻而行诊断性回结肠镜检查。结肠镜检查显示末端回肠正常，而整个结肠的黏膜呈红斑状，有轻微的连续模式水肿，在左半结肠更为明显。实验室检查显示嗜酸粒细胞轻度升高，生化检查无明显异常，进一步的临床和实验室检查也无明显异常。组织学显示嗜酸性结肠炎和克罗恩病的重叠表现。患者开始使用美沙拉嗪 2.4，效果非常好。文献复习表明，嗜酸粒细胞在炎症性肠病以及嗜酸性结肠炎中的受累范围广泛，包括一些与本文所述病例相似的特殊情况。
