Eosinophilic gastroenteritis with severe gastrointestinal intolerance: A case report and literature review

嗜酸性粒细胞性胃肠炎伴严重胃肠道不耐受:病例报告及文献综述

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Abstract

Eosinophilic gastroenteritis is a rare gastrointestinal disease characterized by eosinophilic infiltration of the gastrointestinal mucosa, muscle layer, or serosal layer. Gastrointestinal symptoms, laboratory tests, imaging, and endoscopy can provide important diagnostic basis for eosinophilic gastroenteritis, but the final diagnosis needs to be confirmed via pathological biopsy. We herein report the case of a middle-aged woman with abdominal pain for 5 days, which was aggravated for 1 day. Gastroscopic pathology showed individual nondiffuse eosinophils (concentration of <10 eosinophils/high power field) in the fundus and antrum. Eosinophils with a maximum concentration of 80/high power field were uniformly distributed in the stroma and specific epithelium of the duodenal bulb. Eosinophils were infiltrated in the submucosa as well as the perivascular and vascular walls of the descending duodenum, with a maximum concentration of approximately 130/high power field. After 5 days of intravenous meprednisolone treatment, the symptoms improved and the patient was discharged healthy. After reviewing the literature, we recommend that if a patient exhibits gastrointestinal symptoms and elevated blood eosinophil levels with co-existing atopic diseases, such as asthma and allergic rhinitis, the clinician should perform gastroenteroscopy and pathological biopsy after ruling out tumor, tuberculosis, and infection.

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