scholarly journals An Atypical Case of Eosinophilic Gastroenteritis Presenting as Hypovolemic Shock

2015 ◽  
Vol 9 (2) ◽  
pp. 142-151 ◽  
Author(s):  
Miguel Martillo ◽  
Jean Abed ◽  
Michael Herman ◽  
Elie Abed ◽  
Wenjing Shi ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Clinical Presentation ◽  
Hypovolemic Shock ◽  
Eosinophilic Gastroenteritis ◽  
Peripheral Eosinophilia ◽  
Diffuse Infiltration ◽  
Severe Diarrhea ◽  
Normal Ranges ◽  
Uncommon Condition ◽  
Definition Of

Eosinophilic gastroenteritis is an uncommon condition characterized by focal or diffuse infiltration of eosinophils in the gastrointestinal tract in the absence of secondary causes. The pathogenesis of this condition is not well understood and its clinical presentation depends on the segment and layer of the gastrointestinal tract affected. The definition of eosinophilic gastroenteritis may be difficult, as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not standardized. We present the case of a 59-year-old male who came to the hospital with hypovolemic shock and lethargy secondary to severe diarrhea. Laboratory analysis was significant for peripheral eosinophilia, and pathology from both the duodenum and colon showed marked eosinophilic infiltration.

scholarly journals Conservative management of eosinophilic enteritis presenting with acute abdominal syndrome

2013 ◽  
pp. 124-127
Author(s):  
Marco Bassi ◽  
Gelorma Belmonte ◽  
Carmelo Luigiano ◽  
Paola Billi ◽  
Angela Salerno ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Relevant Literature ◽  
Inflammatory Cells ◽  
Therapeutic Strategies ◽  
Acute Onset ◽  
Peripheral Eosinophilia ◽  
Diffuse Infiltration ◽  
Appropriate Therapy ◽  
Specific Symptoms

Eosinophilic enteritis, an increasing recognized condition, is rare and often presents with non-specific symptoms. We report a case of a 46-year old female who presented with acute onset abdominal pain and nausea associated with ascites, small bowel thickening and peripheral eosinophilia. Diagnosis was confirmed by biopsies taken at esophagogastroduodenoscopy demonstrating diffuse infiltration by inflammatory cells, mainly eosinophils. Appropriate therapy was instituted. The patient recovered well and was symptom-free at 1-month follow up. In this report, we discuss the clinical presentation and the diagnostic criteria of the eosinophilic enteritis, and examine the pathophysiological theories and therapeutic strategies. The relevant literature on eosinophilic enteritis is summarized.

scholarly journals Eosinophilic gastroenteritis: a case report and review of the literature

2012 ◽  
Author(s):  
Paolo Biagi ◽  
Luigi Abate ◽  
Carmine Mellone ◽  
Stefania Salvadori ◽  
Andrea Peccetti ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Eosinophilic Gastroenteritis ◽  
Unknown Etiology ◽  
Peripheral Eosinophilia ◽  
Review Of The Literature ◽  
Radiological Findings ◽  
Complex Disorder ◽  
Colonic Involvement ◽  
Histologic Pattern

BackgroundEosinophilic gastroenteritis (EoG) is a rare disease of unknown etiology characterized by patchy or diffuse eosinophilic infiltration of the gastrointestinal tract wall. As clinical presentation and endoscopic/ radiological findings are nonspecific, diagnosis may only be ascertained by histologic findings.Clinical case This article presents a case of EoG with associated colonic involvement but without peripheral eosinophilia. Although no allergy could be demonstrated, the clinical symptoms and histologic pattern of diffuse eosinophilic mucosal infiltration disappeared after steroid therapy, as discovered by a careful endoscopic follow-up.Discussion Current concepts of this complex disorder and a review of the literature are presented.

scholarly journals Successful use of montelukast in eosinophilic gastroenteritis: a case report and a literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emran A. El-Alali ◽  
Ibrahim M. Abukhiran ◽  
Tarik Z. Alhmoud
Keyword(s):  
Gastrointestinal Tract ◽  
Literature Review ◽  
Eosinophilic Gastroenteritis ◽  
Second Line ◽  
Peripheral Eosinophilia ◽  
Adult Case ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Leukotriene Antagonist

Abstract Background Eosinophilic gastrointestinal disorders, also known as eosinophilic gastroenteritis, are rare inflammatory conditions characterized by eosinophilic infiltration of different parts of the gastrointestinal tract, along with peripheral eosinophilia in most cases. Other known causes for gut eosinophilic infiltration must be excluded to confirm the diagnosis of eosinophilic gastroenteritis. Symptoms of the disorder depend on the affected gastrointestinal tract segment and depth of involvement. Treatment includes systemic glucocorticoids and/or dietary therapy with an empiric elimination diet. Second line therapies include the leukotriene receptor antagonist montelukast, and other anti-allergy drugs such as mast cell stabilizers (including cromolyn and the H1-antihistamine ketotifen), suplatast tosilate which is a selective Th-2 cytokines (IL-4 and IL-5) inhibitor, and the monoclonal anti-IgE antibody omalizumab. We report a case of eosinophilic gastroenteritis who was successfully treated and achieved remission with montelukast as an initial monotherapy. Upon extensive literature review, this represents the second reported adult case of eosinophilic gastroenteritis who responds to montelukast alone as a first line therapy. Case presentation A 49-year-old female presented with recurrent abdominal pain, vomiting, diarrhea and unexplained eosinophilia. She was diagnosed with eosinophilic gastroenteritis and was successfully treated with montelukast monotherapy. After 7 days of therapy, the patient responded well and had complete resolution of her gastrointestinal symptoms and peripheral eosinophilia. Patient remained in remission on follow-up after 12 months. We reviewed the literature for leukotriene antagonist use in the treatment of eosinophilic gastroenteritis and included the cases treated with the leukotriene antagonist montelukast as an initial therapy or as a second line therapy for refractory disease. Conclusion Montelukast may be an effective treatment for eosinophilic gastroenteritis, either alone or in combination with systemic steroids or ketotifen. Our patient is the second reported adult case of eosinophilic gastroenteritis who responded to montelukast alone as a first line therapy. Further studies and clinical trials are required to confirm efficacy compared to standard therapy.

scholarly journals A Case of Eosinophilic Gastroenteritis with Ascites

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Erkan Caglar ◽  
Aslı Sezgin Caglar ◽  
Suut Gokturk ◽  
Ahmet Dobrucali
Keyword(s):  
Differential Diagnosis ◽  
Gastrointestinal Tract ◽  
Laboratory Testing ◽  
Clinical Presentation ◽  
Immunoglobulin E ◽  
Endoscopic Examination ◽  
Eosinophilic Gastroenteritis ◽  
Eosinophilic Infiltration ◽  
Pathologic Findings ◽  
Upper Gastrointestinal

Eosinophilic gastroenteritis is a rare disorder of unknown cause characterized by focal or diffuse eosinophilic infiltration of gastrointestinal tract, especially the stomach and duodenum. Its clinical presentation depends on which segment of gastrointestinal tract is affected and on the depth of eosinophilic infiltration in the affected segment. We present a case of a 35-year-old male with abdominal distention for six months. Laboratory testing revealed elevated eosinophil count and serum immunoglobulin E (IgE) levels. In abdominal tomography, ascites was observed, and eosinophilic infiltration was detected in duodenum biopsy samples, collected during endoscopic examination of upper gastrointestinal system. Clinical and pathologic findings of the patient responded to steroid dramatically. Even though their comorbidity is rare, eosinophilic gastroenteritis should be considered in differential diagnosis of patients with unspecified ascites.

scholarly journals Metastatic Melanoma Presenting as Intussusception in an 80-Year-Old Man: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Sarah Alghamdi ◽  
Yumna Omarzai
Keyword(s):  
Differential Diagnosis ◽  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Metastatic Melanoma ◽  
Clinical Presentation ◽  
Gastrointestinal Symptoms ◽  
Common Site ◽  
Neoplastic Process ◽  
History Of ◽  
Uncommon Neoplasm

Malignant melanoma of the gastrointestinal tract is an uncommon neoplasm that could be primary or metastatic. Small intestine represents the most common site for the metastatic melanoma; however, it could be found anywhere in the gastrointestinal tract. Intussusception is a rare cause of intestinal obstruction in adults compared to children. In 90% of the cases, the underlying cause can be found, and in 65% of the cases, intussusception is caused by the neoplastic process. The majority of the neoplasms are benign, and about 15% are malignant. Metastatic melanoma is one of the most common metastatic malignancies to the gastrointestinal tract; however, the premortem diagnosis is rarely made. Here, we report an uncommon clinical presentation of metastatic melanoma causing intussusception in an 80-year-old man. This diagnosis should be considered in a differential diagnosis in any patient who presents with gastrointestinal symptoms and a history of melanoma.

Novel Route of Sirolimus Administration in a Neonate

2017 ◽  
Vol 31 (2) ◽  
pp. 167-168 ◽  
Author(s):  
Ashley B. Clark ◽  
Indira Chandrasekar ◽  
Jennee Nickleson
Keyword(s):  
Gastrointestinal Tract ◽  
Buccal Mucosa ◽  
Intestinal Perforation ◽  
Clinical Presentation ◽  
Serum Levels ◽  
Intestinal Lesion ◽  
Term Newborn ◽  
Enteral Administration

A term newborn presented with widespread cutaneous erythematous to bluish lesions since birth. He had extensive lesions in the gastrointestinal tract, brain, retina, heart, and bones. He also developed an intestinal perforation due to erosion of an intestinal lesion. Due to his critical status and clinical presentation, he was initially diagnosed with multifocal lymphangioendotheliomatosis with thrombocytopenia (MLT), and sirolimus treatment was initiated. Sirolimus was given by buccal route in this nonfeeding patient. Therapeutic serum levels were obtained comparable to enteral administration. Buccal mucosa was an effective novel route of sirolimus administration in this patient.

CONGENITAL SUCRASE-ISOMALTASE DEFICIENCY

PEDIATRICS ◽  
1972 ◽  
Vol 49 (6) ◽  
pp. 847-853
Author(s):  
I. Antonowicz ◽  
J. D. Lloyd-Still ◽  
K. T. Khaw ◽  
H. Shwachman
Keyword(s):  
Growth And Development ◽  
Clinical Presentation ◽  
Quantitative Estimation ◽  
Failure To Thrive ◽  
Normal Growth ◽  
Significant Rise ◽  
Small Intestinal Mucosa ◽  
Severe Diarrhea ◽  
Young Infants ◽  
Small Intestinal

Observations over a period of 6 years are reported on 10 children in whom the diagnosis of congenital sucrase isomaltase deficiency (SID) was confirmed by quantitative estimation of disaccharidase activity of the small intestinal mucosa. Repeat biopsies were performed on eight of the ten patients and showed no evidence that sucrase isomaltase activity is acquired. Sucrose tolerance tests (2 gm/kg) showed no significant rise in blood glucose in the seven patients in whom they were performed. This condition may appear in young infants with severe diarrhea resulting in a malabsorption syndrome and failure to thrive. It may also be manifest in a milder clinical presentation with bothersome diarrhea in spite of normal growth and development in the older infant or young child. The diagnosis in this latter group can be difficult, and is frequently missed.

Eosinophilic gastroenteritis: a case report and a review of eosinophilic gastrointestinal disorders

2013 ◽  
pp. 166-171 ◽  
Author(s):  
Chiara Benatti ◽  
Carla Sacchetti ◽  
Antonio Pedrazzi ◽  
Claudio Gollini ◽  
Federica Vecchi ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
White Cell Count ◽  
Clinical History ◽  
Eosinophilic Gastroenteritis ◽  
Endoscopic Biopsy ◽  
Gastrointestinal Disorders ◽  
Abdominal Ultrasonography ◽  
Benign Condition ◽  
Peritoneal Effusion ◽  
Eosinophilic Gastrointestinal Disorders

Background: Despite its uncommon occurrence, eosinophilic gastroenteritis is one of the most important primary eosinophilic gastrointestinal disorders. These are defined as disorders that selectively affect the gastrointestinal tract with eosinophil-rich inflammation in the absence of known causes for eosinophilia. The disorders include eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, eosinophilic enteritis and eosinophilic colitis. Aim of the study: This review focuses on the epidemiology, pathophysiology, clinical features and treatment of primary eosinophilic gastrointestinal disorders with particular attention to primary eosinophilic gastroenteritis. Clinical case: We report a case of a 32-years-old woman that was admitted to our Hospital complaining of abdominal pain, ascites and diarrhea. Laboratory investigations showed a white cell count of 15.1 thousands/mm3 with eosinophilia; other laboratory studies were within the normal limits. Abdominal ultrasonography demonstrated peritoneal effusion and cytological analysis revealed a prevalence of eosinophils in the ascites. The multiple endoscopic biopsies were normal. However, the clinical history, and the laboratory, radiological and endoscopic findings gave a firm diagnosis of the serosal form of primary eosinophilic gastroenteritis. Discussion: This is a rare, benign condition, pathologically characterized by an important eosinophilic infiltration of the wall of the digestive tract and presents a constellation of symptoms that are related to the degree and area of the gastrointestinal tract affected. Primary eosinophilic gastroenteritis encompasses multiple disease entities subcategorized into three types on the basis of the level of histologic involvement: mucosal, muscolaris and serosal forms. Every layer of the gastrointestinal tract can be involved, so that endoscopic biopsy can be normal in patients with the muscolaris subtype, serosal subtype, or both.

scholarly journals ENVENIMATIONS VIPERINES

2021 ◽  
Vol 9 (09) ◽  
pp. 432-437
Author(s):  
N. Tajellijiti ◽  
◽  
H. Errifaiy ◽  
N. Boukoub ◽  
Y. Elouardi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hypovolemic Shock ◽  
Public Health Problem ◽  
Cost Of Care ◽  
Symptomatic Therapy ◽  
Essential Components ◽  
Life Threatening ◽  
Biological Criteria ◽  
Definition Of ◽  
General Sign

Rational:The viper envenomations are a real public health problem in Morocco more deaths are reported each year. It is a medical-surgical emergency which can be daunting and life-threatening, as well as the patients functional prognosis. Patients and Methods or Material and Methods:We present 24 cases of serious viper envenomation, on a retrospective study extended over a period of 9 years from 2010 to 2019, and through a literature review we clarify the following aspects: epidemiological, pathophysiological, clinical and therapeutic. Inclusion criteria: The presence of traces of hooks with at least one locoregional and / or general sign of envenomation. The actual presence of the snake in question and / or its description by a witness or the victim. Results:This is a retrospective study that interested 12 men and 13 women, mean age 41 years. The bites were due to vipers, the species was known cerastescerastes type in two cases, MacroviperaMauritanica in one case. 13 patients had a consumptive coagulopathy table with two cases of ischemic stroke, one case of hypovolemic shock and 4 cases of hemorrhagic shock, ten patients had compartment syndrome treated by emergency fasciotomy discharge.11 patients received anti venom serum with clinical improvement and reduction of complications. Discussion:The poison of vipers is a chemical proteinaceous with two essential components: the toxins and enzymes. These proteins are responsible for the observed symptoms. The severity of envenomation is related to the plasma concentration of the venom. The definition of early clinical and biological criteria of gravity has envenomation better assess and clarify the therapeutic indications. Processing viper envenomation considerably simplified over the past decade. The medical care is based on a symptomatic therapy component associated with a specific serum therapy. On early treatment with these specific immunoglobulins from the onset of signs of grades II or III envenomation reduces morbidity, sequelae and the total cost of care. Conclusion:Improving the prognosis of envenomation involves information education and good care that can only be achieved through close collaboration between.

scholarly journals A Comprehensive Review of Infectious Granulomatous Diseases of the Gastrointestinal Tract

2021 ◽  
Vol 2021 ◽  
pp. 1-20
Author(s):  
Shivantha Amarnath ◽  
Liliane Deeb ◽  
Jobin Philipose ◽  
Xiaomin Zheng ◽  
Vivek Gumaste
Keyword(s):  
Gastrointestinal Tract ◽  
Inflammatory Reaction ◽  
Hypersensitive Response ◽  
Clinical Presentation ◽  
Histological Findings ◽  
Comprehensive Review ◽  
Clinical Presentations ◽  
Autoimmune Conditions ◽  
Granulomatous Diseases ◽  
Granulomatous Disorders

A granuloma is defined as a localized inflammatory reaction or a hypersensitive response to a nondegradable product leading to an organized collection of epithelioid histiocytes. Etiologies of granulomatous disorders can be divided into two broad categories: infectious and noninfectious (autoimmune conditions, toxins, etc.) causes. The endless list of causalities may prove challenging for gastroenterologists and pathologists to formulate a list of clearly defined differentials. This is true when distinguishing these etiologies based on various clinical presentations and endoscopic and histological findings. We aim to provide a comprehensive review of some of the frequent and rare infectious granulomatous diseases of the gastrointestinal tract documented in the literature to date. We provide an overview of each infectious pathology with an emphasis on epidemiology, clinical presentation, and endoscopic and histologic findings, in addition to treatment.

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