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Eosinophilic gastroenteritis and gluten-sensitive enteropathy in the same patient
Joseph H Butterfield1, Joseph A Murray
1Division of Allergic Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, U.S.A. butterfield.joseph@mayo.edu
Journal of Clinical Gastroenterology
|April 18, 2002
Summary
This case study highlights a rare dual diagnosis of eosinophilic gastroenteritis and gluten-sensitive enteropathy in a young man. Treatment requires addressing each condition separately for optimal patient outcomes.
Area of Science:
- Gastroenterology
- Immunology
- Allergy
Background:
- Presents a rare case of a 19-year-old male with concurrent eosinophilic gastroenteritis and gluten-sensitive enteropathy.
- Investigates the clinical and laboratory features associated with these co-occurring gastrointestinal disorders.
Observation:
- The patient exhibited elevated total serum immunoglobulin E (IgE) and positive radioallergosorbent test (RAST) results to multiple foods.
- Hepatitis B vaccination prior to symptom onset did not elicit an antibody response or allergic reaction.
Findings:
- A gluten-free diet normalized endomysial antibody titers, indicating efficacy for gluten-sensitive enteropathy.
- Despite dietary changes, total serum IgE levels and eosinophil counts remained elevated, suggesting persistent eosinophilic gastroenteritis.
- Recurrent vomiting and abdominal pain necessitated prednisone treatment.
Implications:
- The simultaneous presentation of these conditions is uncommon, necessitating individualized therapeutic strategies.
- Highlights the complex interplay between immune responses, diet, and gastrointestinal inflammation.
- Underscores the importance of comprehensive diagnostic and treatment approaches for complex gastrointestinal presentations.
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