EOSINOPHILIC GASTROENTERITIS WITH PREDOMINANT MUSCULAR LAYER DISEASE: FEATURE OF ENDOSCOPIC ULTRASONOGRAPHY

Ascites in a Young Woman: A Rare Presentation of Eosinophilic Gastroenteritis

Introduction

Eosinophilic gastroenteritis (EGE) is a rare idiopathic disease that can affect one or more organs of the digestive tract. It has an estimated incidence of 1–20 cases per 100,000 patients. Klein et al. classified EGE into 3 subtypes: predominant mucosal, muscular, or subserosal.

Clinical Case

We report a case of a 32-year-old woman, who presented with diffuse abdominal pain, nausea, postprandial infarction, diarrhea, and moderate ascites of three-week evolution. The rest of physical examination did not show alterations. The past medical history was unremarkable. Laboratory test results revealed peripheral blood eosinophilia. Abdominal CT scan revealed diffuse and concentric parietal thickening of the distal 2/3 of esophagus, moderate volume ascites, and small bowel wall thickening and distension on the left quadrants. The paracentesis revealed 93.3% of eosinophils. The colon biopsies evidenced an increase in the number of eosinophils. Secondary causes of eosinophilia were excluded. The patient was treated with oral prednisolone 40 mg/day with immediate clinical and analytical improvement.

Conclusion

Eosinophilic gastroenteritis is a rare condition with a nonspecific and highly variable clinical presentation, which requires a high level of clinical suspicion. It is a diagnosis of exclusion. Secondary causes of eosinophilia such as intestinal tuberculosis, parasitosis, and malignant neoplasms should be excluded.

Eosinophilic gastritis with idiopathic thrombocytopaenic purpura: coincidence or association?

A 70-year-old woman with a 3-year history of a nonhealing benign gastric ulcer developed spontaneous bruising and mouth ulceration. After haematological investigations, a diagnosis of idiopathic thrombocytopaenic purpura was made. At this stage, repeat biopsies of the gastric ulcer revealed features of eosinophilic gastritis. This is the first report of simultaneous diagnosis of idiopathic thrombocytopaenic purpura and eosinophilic gastritis. Both conditions are considered to be autoimmune induced and could be causally related. Oral steroid therapy led to a full recovery from both conditions.