Santos Carina, Morgado Francisco, Blanco Celestina, Parreira João, Costa João, Rodrigues Lara, Marfull Luís, Cardoso Patrícia
Department of Internal Medicine, Radiology, University Hospital Center "Sousa Martins", Guarda, Portugal.
Case Rep Gastrointest Med. 2018 May 10;2018:1586915. doi: 10.1155/2018/1586915. eCollection 2018.
Eosinophilic gastroenteritis (EGE) is a rare idiopathic disease that can affect one or more organs of the digestive tract. It has an estimated incidence of 1-20 cases per 100,000 patients. Klein et al. classified EGE into 3 subtypes: predominant mucosal, muscular, or subserosal.
We report a case of a 32-year-old woman, who presented with diffuse abdominal pain, nausea, postprandial infarction, diarrhea, and moderate ascites of three-week evolution. The rest of physical examination did not show alterations. The past medical history was unremarkable. Laboratory test results revealed peripheral blood eosinophilia. Abdominal CT scan revealed diffuse and concentric parietal thickening of the distal 2/3 of esophagus, moderate volume ascites, and small bowel wall thickening and distension on the left quadrants. The paracentesis revealed 93.3% of eosinophils. The colon biopsies evidenced an increase in the number of eosinophils. Secondary causes of eosinophilia were excluded. The patient was treated with oral prednisolone 40 mg/day with immediate clinical and analytical improvement.
Eosinophilic gastroenteritis is a rare condition with a nonspecific and highly variable clinical presentation, which requires a high level of clinical suspicion. It is a diagnosis of exclusion. Secondary causes of eosinophilia such as intestinal tuberculosis, parasitosis, and malignant neoplasms should be excluded.
嗜酸性粒细胞性胃肠炎（EGE）是一种罕见的特发性疾病，可累及消化道的一个或多个器官。据估计，其发病率为每10万名患者中有1 - 20例。Klein等人将EGE分为3种亚型：黏膜为主型、肌层为主型或浆膜下为主型。
我们报告一例32岁女性患者，出现弥漫性腹痛、恶心、餐后梗塞、腹泻以及病程三周的中度腹水。其余体格检查未发现异常。既往病史无特殊。实验室检查结果显示外周血嗜酸性粒细胞增多。腹部CT扫描显示食管远端2/3弥漫性、同心性壁增厚，中度腹水，左下腹小肠壁增厚及扩张。腹腔穿刺显示嗜酸性粒细胞占93.3%。结肠活检显示嗜酸性粒细胞数量增加。排除了嗜酸性粒细胞增多的继发性原因。该患者接受口服泼尼松龙40mg/天治疗，临床和分析结果立即改善。
嗜酸性粒细胞性胃肠炎是一种罕见疾病，临床表现非特异性且高度多变，需要高度的临床怀疑。它是一种排除性诊断。应排除嗜酸性粒细胞增多的继发性原因，如肠结核、寄生虫病和恶性肿瘤。
