Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 450, Minneapolis, MN 55455, USA.
Gastroenterol Res Pract. 2011;2011:857508. doi: 10.1155/2011/857508. Epub 2011 Jul 10.
Eosinophilic colitis is a rare form of primary eosinophilic gastrointestinal disease that is poorly understood. Neonates and young adults are more frequently affected. Clinical presentation is highly variable depending on the depth of inflammatory response (mucosal, transmural, or serosal). The pathophysiology of eosinophilic colitis is unclear but is suspected to be related to a hypersensitivity reaction given its correlation with other atopic disorders and clinical response to corticosteroid therapy. Diagnosis is that of exclusion and differential diagnoses are many because colonic tissue eosinophilia may occur with other colitides (parasitic, drug-induced, inflammatory bowel disease, and various connective tissue disorders). Similar to other eosinophilic gastrointestinal disorders, steroid-based therapy and diet modification achieve very good and durable responses. In this paper, we present our experience with this rare pathology. Five patients (3 pediatric and 2 adults) presented with diarrhea and hematochezia. Mean age at presentation was 26 years. Mean duration of symptoms before pathologic diagnosis was 8 months. Mean eosinophil count per patient was 31 per high-power field. The pediatric patients responded very well to dietary modifications, with no recurrences. The adult patients were treated with steroids and did not respond. Overall mean followup was 22 (range, 2-48) months.
嗜酸性结肠炎是一种罕见的原发性嗜酸性胃肠道疾病，其发病机制尚不清楚。新生儿和年轻人更易受影响。临床表现高度可变，取决于炎症反应的深度（黏膜、黏膜下或浆膜）。嗜酸性结肠炎的病理生理学尚不清楚，但由于其与其他特应性疾病相关，且对皮质类固醇治疗有临床反应，故怀疑与过敏反应有关。诊断是排他性的，鉴别诊断很多，因为结肠组织嗜酸性粒细胞增多可能与其他结肠炎（寄生虫、药物诱导、炎症性肠病和各种结缔组织疾病）有关。与其他嗜酸性胃肠道疾病类似，基于类固醇的治疗和饮食改变可获得非常好且持久的反应。本文介绍了我们对这种罕见病理的经验。5 名患者（3 名儿科和 2 名成人）表现为腹泻和血便。发病时的平均年龄为 26 岁。病理诊断前症状的平均持续时间为 8 个月。每位患者的平均嗜酸性粒细胞计数为 31/高倍视野。儿科患者对饮食改变反应良好，无复发。成年患者接受类固醇治疗后无反应。总的平均随访时间为 22 个月（范围，2-48 个月）。
