Eosinophilic gastroenteritis: a description of a new case with serous affectation

We discuss a case of a 51 year old female who presented periodic episodes of abdominal pain, nausea and vomitus consisting of food elements and in addition in the last crisis presented ascites and increased abdominal circumference. The laboratory studies performed included the remarkable increase in eosinophils found in peripheral blood and ascitic fluid with the rest of the laboratory findings within the normal limits (biochemical, proteinogram, Igs, urine and stool examination, and negative food provocation test). Radiography demonstrated swelling of the gastric wall at antral level and the small intestinal wall. A gastric sample was taken via endoscopy which established the diagnosis of EG. EG is a disease of still disputable etiopathogenesis. Some think it is mediated by type I hypersensitivity mechanism and others (like our case) mediated by immunologic mechanism different from atopy which on occasions form part of a systemic feature. Regarding the role of eosinophil, it seems to be important as latest studies have found a relation between the degree of cell degranulation and the degree of histologic lesion. From the distinct form of EG (muscular, mucosa, serosa), EG with involvement of the serosa layer is the less frequent. It is usually associated to some other layer (generally muscular) and presenting ascites. Some authors denominate mixed-type EG to these forms whereby important involvement of more than one layer of the digestive tract is demonstrated.