Eosinophilic gastroenteritis. Three cases involving each of the anatomo-clinical variants

Three patients suffering from eosinophilic gastroenteritis belonging to each of the three anatomo-clinical forms are involved in this study. The disease has a high blood eosinophilia and in the anatomo-pathological studies it is established that there is an eosinophilic infiltration in some portion of the gastrointestinal tract. The localization of this infiltration in the mucous, muscular or serous layers of the digestive canal allows the three varieties to be distinguished, each one having an individual clinical pattern. In the patient with the mucous form, analytical and clinical evidence of atopy is observed, as well as certain types of food which trigger off the symptoms. The exclusion diet and the membrane-stabilizing drugs, disodium cromoglycate and ketotifen produce clear therapeutic effects. Conversely, in those patients where the eosinophilic infiltration is in the muscular or serous layers, no food inductors are found and a therapy based on diet with subsequent administration of the above-mentioned drugs proves to be ineffective. The course of the disease in these cases is unpredictable and steroid drugs must be used frequently. The clinical, anatomo-pathological and analytical characteristics, together with the therapeutic results and subsequent development, lead us to assume a reaginic immunological mechanism in the mucous membrane, but, in the other forms there is no clear pathogenic mechanism to explain the anatomo-pathological findings and the clinical symptoms.