Salazar F, Salazar F
Dpto. de Gastroenterología, Clínica Ricardo Palma, Lima, Perú.
Rev Gastroenterol Peru. 1995 May-Aug;15(2):176-80.
Eosinophilic Gastroenteritis (EGE) is a disease of unknown etiology characterized by peripheral eosinophilia associated with eosinophilic infiltration of the layers of the wall of the gastrointestinal tract. Clinical manifestations are related to the level of histologic infiltration in the wall, and the segment of GI tract involved. Two cases of EGE are reported with different clinical presentations: One case is chronic, with recurrent ascites of 13 years duration and gastric outlet obstruction; the other case is acute with 14 days of abdominal symptoms and peripheral eosinophilia. We describe the diagnostic work-up and exclude other causes of eosinophilia. In case #1 with a chronic illness, the infiltration of the gastric wall was mainly of the muscular layer and serosa, and the clinical, radiological, endoscopic and surgical characteristics were of an infiltrative disease of the stomach, that was aggressively treated with total gastrectomy. The correct diagnosis in this case was established in the pathologic examination of the surgical specimen. In case #2 the disease was acute, the eosinophilic infiltrate was limited to the mucosa layer of the small and large bowel, and the diagnosis was established in an endoscopic biopsy specimen. Case #1 had a recurrence of ascites 5 years after total gastrectomy with peripheric and ascitic eosinophilia. Both cases were treated with low doses of Prednisone tapered off in a few days, with rapid clinical remission.
嗜酸性粒细胞性胃肠炎(EGE)是一种病因不明的疾病,其特征为外周血嗜酸性粒细胞增多,并伴有胃肠道壁各层的嗜酸性粒细胞浸润。临床表现与胃肠道壁组织学浸润程度及受累胃肠道节段有关。本文报告了两例临床表现不同的EGE病例:一例为慢性病例,反复腹水13年,伴有胃出口梗阻;另一例为急性病例,有14天的腹部症状及外周血嗜酸性粒细胞增多。我们描述了诊断检查过程并排除了嗜酸性粒细胞增多的其他原因。在病例1中,该慢性疾病患者胃壁浸润主要在肌层和浆膜层,其临床、放射学、内镜及手术特征均显示为胃部浸润性疾病,遂行全胃切除术进行积极治疗。该病例的正确诊断是在手术标本的病理检查中确立的。在病例2中,疾病为急性,嗜酸性粒细胞浸润局限于小肠和大肠黏膜层,诊断通过内镜活检标本确立。病例1在全胃切除术后5年出现腹水复发,外周血及腹水中嗜酸性粒细胞增多。两例均采用低剂量泼尼松治疗,数天内逐渐减量,临床症状迅速缓解。