Giudici Gabriele, Ribaldone Davide G, Astegiano Marco, Saracco Giorgio M, Pellicano Rinaldo
Unit of Gastroenterology, Department of Medical Sciences, University of Turin, Turin, Italy.
Department of Surgical Sciences, University of Turin, Turin, Italy.
Minerva Gastroenterol Dietol. 2020 Jun;66(2):157-163. doi: 10.23736/S1121-421X.20.02656-2. Epub 2020 Jan 28.
Eosinophilic colitis (EC) is a rare inflammatory disease included in the chapter of eosinophilic gastrointestinal disorders (EGIDs), diagnosed by the presence of primary eosinophilic infiltrate in the colon wall in symptomatic patients. While the etiology of primary colonic eosinophilia is unknown, several conditions are involved in the pathogenesis of secondary eosinophilic colonic infiltrate (food allergens, parasitic infections, drugs), which have to be excluded in order to correctly diagnose the primary form of the disease. Up to now, EC is lacking of codified guidelines regarding diagnostic criteria (especially eosinophil threshold values) and treatment, thus a correct approach to EC remains very challenging. Imaging, laboratory tests and endoscopy might be helpful in ruling out other mimic conditions, but EC is still a diagnosis of exclusion. Several treatment options are feasible, but most of the evidences are drawn from case reports and small case series, thus limiting their value. We carried out a review of the current literature to evaluate the more appropriate and modern clinical strategy for diagnosis and management of EC.
嗜酸性粒细胞性结肠炎（EC）是一种罕见的炎症性疾病，属于嗜酸性粒细胞性胃肠道疾病（EGIDs）章节，通过有症状患者结肠壁中存在原发性嗜酸性粒细胞浸润来诊断。虽然原发性结肠嗜酸性粒细胞增多症的病因尚不清楚，但继发性嗜酸性粒细胞性结肠浸润的发病机制涉及多种情况（食物过敏原、寄生虫感染、药物），为正确诊断该疾病的原发性形式，必须排除这些情况。到目前为止，EC在诊断标准（尤其是嗜酸性粒细胞阈值）和治疗方面缺乏规范的指南，因此正确处理EC仍然极具挑战性。影像学检查、实验室检查和内镜检查可能有助于排除其他类似病症，但EC仍然是一种排除性诊断。有几种治疗方案是可行的，但大多数证据来自病例报告和小病例系列，因此其价值有限。我们对当前文献进行了综述，以评估诊断和管理EC更合适、更现代的临床策略。
