[Two cases of eosinophilic gastroenteritis whose causative allergens are usefully diagnosed by patch test]

Area of Science:

• Allergy and Immunology
• Gastroenterology

Background:

• Eosinophilic gastroenteritis (EG) is a rare condition characterized by eosinophilic infiltration of the gastrointestinal tract.
• The causative allergens for EG are often unknown, but food and drug sensitivities have been implicated.
• Identifying specific triggers is crucial for effective management and treatment of EG.

Observation:

• Two patients with pollinosis presented with gastrointestinal symptoms and peripheral eosinophilia.
• Case 1: A 67-year-old woman experienced chest oppression and heartburn after dental treatment, with elevated eosinophils and positive specific IgE to cedar and cypress.
• Case 2: A 42-year-old woman with pollinosis and asthma reported recurrent urticaria, heartburn, and diarrhea, exhibiting significant peripheral eosinophilia and elevated IgG.

Findings:

• Both patients were diagnosed with eosinophilic gastroenteritis due to significant eosinophil infiltration in the gastrointestinal mucosa.
• Patch testing identified formalin and 2-hydroxyethyl methacrylate as potential allergens in Case 1.
• Patch testing identified garlic and sesame as potential allergens in Case 2, with symptom improvement upon their removal.

Implications:

• Patch testing can be a valuable tool for identifying specific environmental and food allergens in patients with eosinophilic gastroenteritis.
• Allergen avoidance based on patch test results can lead to symptom improvement in EG patients.
• This study highlights the importance of considering environmental and food allergens in the etiology of eosinophilic gastroenteritis.