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Eosinophilic Enteritis: A Delayed Diagnosis.

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Eosinophilic gastrointestinal disorders (EGIDs) involve eosinophil buildup in the GI tract, causing varied symptoms. Diagnosis requires biopsy, and treatment with diet/steroids often resolves symptoms effectively.

Keywords:
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Area of Science:

  • Gastroenterology
  • Immunology
  • Pathology

Background:

  • Eosinophilic gastrointestinal disorders (EGIDs) are rare conditions characterized by eosinophil infiltration in the GI tract.
  • Symptoms vary widely depending on the affected GI segment and layer (mucosal, muscular, serosal).

Purpose of the Study:

  • To present a case study of a 59-year-old male with EGID, highlighting diagnostic challenges and treatment outcomes.
  • To emphasize the diagnostic criteria and therapeutic strategies for eosinophilic enteritis.

Main Methods:

  • Diagnostic workup included computed tomography (CT) scans, esophagogastroduodenoscopies, colonoscopies, video capsule study, and balloon enteroscopy.
  • Histopathological examination of biopsies confirmed diagnosis with >50 eosinophils/high-power field in the duodenum to proximal ileum.
  • Treatment involved elimination diets and corticosteroids.

Main Results:

  • The patient presented with nausea, abdominal pain, and weight loss over two months.
  • Endoscopic findings revealed duodenal and proximal ileal erythema, scalloping, exudate, and villous blunting.
  • Histopathology confirmed eosinophilic enteritis, and treatment led to symptom resolution.

Conclusions:

  • EGIDs require extensive investigation, often involving multiple endoscopic procedures.
  • Histopathology is crucial for diagnosis, with specific eosinophil counts defining the condition.
  • Therapy with elimination diets and steroids is highly effective, achieving symptom and endoscopic resolution in most cases.