Eosinophilic gastroenteritis

Dr Henry Knipe and Dr Amir Rezaee et al.

Eosinophilic gastroenteritis (EG) is an uncommon disease characterised by diffuse infiltration of any or all layers of gut wall by eosinophils. 

EG is an uncommon but not rare disease with slight male predominance, it can affect any age group but usually patients present in their 3rd to 5th decades of life. 

  • self limiting disorder in majority of cases
  • patients may present with dysphagia, food impaction, abdominal pain, nausea, vomiting, or diarrhea depending on the site of involvement
  • in severely affected children it may result in growth retardation
  • chronic inflammatory disorder of GI wall of undetermined pathophysiology  although atopy-related genes, inflammatory cells and mediators play a role in the pathogenesis of EG
  • history of allergy, in particular food allergy, is present in approximately 50% of cases
  • more than 60% of cases show peripheral eosinophilia 
  • on biopsy there is evidence of mucosal oedema and infiltration of the eosinophils, polymorphonuclear leukocytes (PMNs), and lymphocytes in different layers of gut wall
Fluoroscopy
  • eosinophilic oesophagitis may show a "ringed oesophagus" (series of ring like strictures), and/or smooth long segment narrowing of esophagus 
  • gastrointestinal involvement is more common
    • virtually always involves gastric antrum and proximal small intestine
    • non-specific mucosal fold thickening and nodularity particularly in gastric antrum, without submucosal edema
    • when chronic, the antrum is narrowed with a nodular "cobblestone" mucosal appearance
CT 
  • CT features are non specific and may show GI wall thickening and submucosal oedema
  • responds well to oral corticosteroids and dietary exclusion 
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Article Information

rID: 20925
Section: Pathology
Synonyms or Alternate Spellings:
  • Eosinophilic oesophagitis
  • Eosinophilic gastroentritis (EG)
  • Eosinophilic gastritis
  • Eosinophilic esophagitis

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