Fall Diary, Gordo Ortega Ana, Allemant Castañeda Eric, Amorena Muro Edurne, Rubio Iturria Saioa
Aparato Digestivo, Hospital Universitario de Navarra, España.
Aparato Digestivo , Hospital Universitario de Navarra, SPAIN.
Rev Esp Enferm Dig. 2024 Sep 5;119. doi: 10.17235/reed.2024.10665/2024.
Primary eosinophilic gastrointestinal disorders are rare, characterized by eosinophilic infiltration without a secondary cause. Although esophageal involvement is most common, any part of the gastrointestinal tract can be affected. We present the case of a male with symptoms of abdominal distension, retrosternal heartburn, sporadic vomiting, and diarrhea. The patient exhibited hypereosinophilia and elevated IgE levels. Ultrasound revealed diffuse small bowel wall thickening and moderate ascites; diagnostic paracentesis showed leukocytosis with a predominance of eosinophils. A gastrocolonoscopy revealed macroscopically normal findings, but biopsies from the duodenum, ileum, and colon revealed marked eosinophilia. Additional tests were negative. The patient was diagnosed with eosinophilic enterocolitis and started on corticosteroid treatment, with satisfactory improvement. Two years later, the patient has not shown new manifestations of the disease. Eosinophilic ascites is a typical manifestation when serosal infiltration. This form of involvement is the least common but has a good prognosis, usually responding well to corticosteroids and without subsequent flares.
原发性嗜酸性粒细胞性胃肠疾病罕见，其特征为嗜酸性粒细胞浸润且无继发原因。尽管食管受累最为常见，但胃肠道的任何部位均可受到影响。我们报告一例男性患者，有腹胀、胸骨后烧心、偶发呕吐及腹泻症状。该患者表现为嗜酸性粒细胞增多及IgE水平升高。超声显示小肠壁弥漫性增厚及中度腹水；诊断性腹腔穿刺显示白细胞增多，以嗜酸性粒细胞为主。胃肠镜检查宏观上未见异常，但十二指肠、回肠及结肠活检显示明显的嗜酸性粒细胞增多。其他检查均为阴性。该患者被诊断为嗜酸性粒细胞性小肠结肠炎，并开始使用皮质类固醇治疗，病情改善满意。两年后，患者未出现该疾病的新表现。嗜酸性腹水是浆膜浸润时的典型表现。这种受累形式最不常见，但预后良好，通常对皮质类固醇反应良好且无后续复发。
