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[Eosinophilic ascites and urticaria]

L Lévêque1, C Michiels, E Collet

  • 1Service de dermatologie, CHU Le Bocage, Dijon, France.

La Revue De Medecine Interne
|October 17, 1998
PubMed
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Serous eosinophilic gastroenteritis is a rare condition causing eosinophilic ascites. This case highlights its unusual presentation with urticaria and normal eosinophil counts, emphasizing the need for careful diagnosis.

Area of Science:

  • Gastroenterology
  • Immunology
  • Internal Medicine

Background:

  • Eosinophilic ascites is uncommon, necessitating investigation into causes like parasitic disease, malignancy, vasculitis, or hypereosinophilic syndrome.
  • Eosinophilic gastroenteritis, particularly the serous subtype, is a rare diagnosis of exclusion associated with eosinophilic ascites, with fewer than 50 cases documented.
  • Serous eosinophilic gastroenteritis is the rarest form, characterized by eosinophilic infiltration of the serosa, often presenting with ascites.

Observation:

  • A 23-year-old woman presented with a unique case of serous eosinophilic gastroenteritis.
  • Unusual clinical features included abdominal pain and ascites concurrent with urticaria episodes.
  • Diagnostic challenges were posed by the absence of peripheral eosinophilia and eosinophils in digestive biopsies.

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Findings:

  • The patient's condition improved with corticosteroid therapy, requiring a maintenance dose of 8 mg/day.
  • The case demonstrated a favorable response to corticosteroid treatment for serous eosinophilic gastroenteritis.
  • Persistent symptoms despite initial treatment necessitated ongoing corticosteroid management.

Implications:

  • This case underscores the importance of considering serous eosinophilic gastroenteritis in patients with unexplained ascites and hypereosinophilia.
  • The association with urticaria suggests a potential link to allergic mechanisms or hypereosinophilic syndrome, necessitating a broad differential diagnosis.
  • Accurate diagnosis and management are crucial, as serous eosinophilic gastroenteritis can mimic other serious conditions.