Maàmouri N, Guellouz S, Belkahla N, Mohsni B, Naija N, Chouaib S, Chaabouni H, Ben Mami N
Service de gastroentérologie B, hôpital La Rabta, 1007 Tunis Jebbari, Tunisia.
Rev Med Interne. 2012 Aug;33(8):421-5. doi: 10.1016/j.revmed.2012.04.016. Epub 2012 May 29.
Eosinophilic gastroenteritis is a rare and heterogeneous disorder characterized by eosinophilic infiltration of one or more layers of the gastrointestinal tract. Although it can involve any part of the gastrointestinal tract, the stomach and the proximal small bowel are the most common sites of involvement. Clinical features depend on which layer and site are involved. We report eight cases of eosinophilic gastroenteritis.
We conducted a retrospective review of consecutive adult cases diagnosed with eosinophilic gastroenteritis from 1990 to 2010. The diagnosis was established by histologic examination of endoscopic biopsy or operative specimen or by the presence of eosinophilic ascites.
Eight patients (three men, five women) were diagnosed with eosinophilic gastroenteritis during the study period. Three out of the eight patients had a history of allergy. All patients had gastrointestinal symptoms. The most common symptoms were abdominal pain, vomiting, weight loss and ascites. Seven patients (87.5%) had hypereosinophilia. Seven patients had involvement of the subserosa and one of the mucosa. Four patients were treated with oral prednisolone. The symptoms in all the patients subsided within one month. The remaining four patients improved spontaneously. Four of our patients were followed-up for at least 2 months (11 to 68 months). A single patient presented a relapse.
Eosinophilic gastroenteritis should be suspected in patients having gastrointestinal discomfort along with peripheral eosinophilia. Definitive diagnosis requires histological demonstrations of eosinophilic infiltration of the gastrointestinal wall or high eosinophilic count in ascites fluid.
嗜酸性粒细胞性胃肠炎是一种罕见的异质性疾病,其特征为胃肠道一层或多层出现嗜酸性粒细胞浸润。虽然它可累及胃肠道的任何部位,但胃和近端小肠是最常受累的部位。临床特征取决于受累的层次和部位。我们报告8例嗜酸性粒细胞性胃肠炎病例。
我们对1990年至2010年连续诊断为嗜酸性粒细胞性胃肠炎的成年病例进行了回顾性研究。通过内镜活检或手术标本的组织学检查或嗜酸性腹水的存在来确立诊断。
在研究期间,8例患者(3例男性,5例女性)被诊断为嗜酸性粒细胞性胃肠炎。8例患者中有3例有过敏史。所有患者均有胃肠道症状。最常见的症状是腹痛、呕吐、体重减轻和腹水。7例患者(87.5%)有嗜酸性粒细胞增多。7例患者浆膜下层受累,1例黏膜受累。4例患者接受口服泼尼松龙治疗。所有患者的症状在1个月内消退。其余4例患者自行好转。我们的4例患者至少随访了2个月(11至68个月)。1例患者出现复发。
对于有胃肠道不适及外周血嗜酸性粒细胞增多的患者应怀疑嗜酸性粒细胞性胃肠炎。确诊需要胃肠道壁嗜酸性粒细胞浸润的组织学证据或腹水中嗜酸性粒细胞计数升高。