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Published on: February 17, 2023
[Clinical analysis of eosinophilic gastroenteritis in six children]
1Department of Gastroenterology, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing 100045, China.
Insights
Eosinophilic gastroenteritis (EG) in children presents with nonspecific gastrointestinal symptoms. Diagnosis requires biopsy, and while blood eosinophil counts can suggest EG, glucocorticoid therapy shows faster symptom and eosinophil count improvement compared to other treatments.
Area of Science:
- Pediatric Gastroenterology
- Allergy and Immunology
- Gastrointestinal Pathology
Context:
- Eosinophilic gastroenteritis (EG) is a rare condition characterized by eosinophilic infiltration of the gastrointestinal tract.
- Clinical presentation can be nonspecific, mimicking other common gastrointestinal disorders in children.
- Accurate diagnosis and effective treatment are crucial for managing pediatric EG.
Purpose:
- To analyze the clinical characteristics, diagnostic findings, and treatment outcomes of eosinophilic gastroenteritis (EG) in a pediatric cohort.
- To evaluate the efficacy of different therapeutic approaches, including glucocorticoids, for managing pediatric EG.
Summary:
- This retrospective study analyzed 6 children diagnosed with EG, revealing diverse gastrointestinal symptoms and elevated blood/bone marrow eosinophil counts.
- Biopsy confirmed EG, with eosinophilic infiltration most prominent in the duodenum.
- Glucocorticoid therapy demonstrated a more rapid improvement in clinical symptoms and normalization of blood eosinophil counts compared to non-glucocorticoid treatments.
Impact:
- Highlights the importance of considering EG in children with unexplained gastrointestinal issues.
- Emphasizes biopsy as the gold standard for EG diagnosis.
- Provides evidence supporting the efficacy of glucocorticoids as a primary treatment for pediatric EG, leading to faster recovery.
Objective:
To analyze the clinical characteristics and treatment of eosinophilic gastroenteritis (EG) in children.
Method:
A retrospective analysis of the clinical manifestation, laboratory test, endoscopy, biopsy, bone marrow examination and treatment of 6 children diagnosed with EG in Beijing Children's Hospital seen from Jun. 2005 to May 2009 was performed.
Result:
Five of the cases were boys and 1 was girl, the range of age was from 2 to 13 years; food allergy test was positive in 4 cases. Clinical manifestations included:abdominal pain, diarrhea, vomiting, digestive tract hemorrhage, and ascites was found in 4 children. The eosinophilic cell count in blood increased in 5 cases [(160 - 13,560) × 10(6)/L]. The percentage of eosinophilic cell in bone marrow increased in 6 cases (0.18 - 0.41). Beside stomach and duodenum, anatomical foci were found in mesentery (5 cases), small intestine (4 cases), colon (3 cases), and esophagus (2 cases). Endoscopy and imaging showed edema, congestion, erosion, ulcer, bile reflux and gastric juice retention. Stomach and duodenum pathological changes included epithelial erosion, large quantities of eosinophilic cell infiltration in lamina propria and scattered lymphoid cells, which were more obvious in duodenum. In the group received glucocorticoid therapy, clinical symptoms disappeared 3 days later, the eosinophilic cell count in blood returned to normal one-week later;in the group of non-glucocorticoid therapy, most of the clinical symptoms disappeared after two weeks. The eosinophilic cell count in blood was still high 5 weeks later.
Conclusion:
Compared to the common gastroenteritis, gastrointestinal symptoms in EG cases were nonspecific, the increase of blood eosinophilic cells can suggest the possibility of EG, but biopsy is the key to the diagnosis of EG. The therapeutic effect of glucocorticoid seemed to be better than non-glucocorticoid therapies in the improvement of clinical symptoms and the decrease of blood eosinophilic cell.
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