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Eosinophilic gastroenteritis: epidemiology, diagnosis and management
Seema Khan1, Susan R Orenstein
1Division of Pediatric Gastroenterology, Children's Hospital of Pittsburgh, University of Pittsburgh and School of Medicine, Pittsburgh, Pennsylvania 15213, USA. seema.khan@chp.edu
Paediatric Drugs
|August 15, 2002
Summary
Eosinophilic gastroenteritis involves eosinophil-driven gastrointestinal inflammation, often linked to food allergies. Diagnosis relies on tissue biopsies, with corticosteroids being a primary treatment, though new therapies show promise.
Area of Science:
- Gastroenterology
- Allergy and Immunology
- Pediatrics
Background:
- Eosinophilic gastroenteritis is a rare disorder of gastrointestinal eosinophilic inflammation.
- Its presentation varies based on eosinophil infiltration depth (mucosal, muscular, serosal).
- Symptoms include abdominal pain, vomiting, and diarrhea, with peripheral eosinophilia in two-thirds of cases.
Purpose of the Study:
- To review the pathophysiology, diagnosis, and management of eosinophilic gastroenteritis.
- To highlight the role of eotaxin in eosinophil production.
- To discuss pediatric-specific considerations and differential diagnoses.
Main Methods:
- Review of existing literature on eosinophilic gastroenteritis.
- Emphasis on diagnostic criteria, including endoscopic biopsies and full-thickness biopsies for deeper infiltration.
- Discussion of treatment strategies and emerging therapies.
Main Results:
- Eosinophilic gastroenteritis is strongly associated with food allergies (70% of cases).
- Pediatric forms include allergic procto-colitis and eosinophilic esophagitis.
- Diagnosis can be challenging due to patchy disease and deeper infiltration subtypes.
Conclusions:
- Prominent tissue eosinophilia on biopsy is diagnostic.
- Corticosteroids are effective but prolonged use is often necessary due to relapsing nature.
- Leukotriene inhibitors show encouraging results, warranting further research.