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Z Gastroenterol 2013; 51(7): 638-642
DOI: 10.1055/s-0033-1335326
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

Clinical Features of Eosinophilic Gastroenteritis with Ascites

Klinische Präsentation der eosinophilen Gastritis mit Aszites
L. Liu
1   Gastroenterology, Nanhai Hospital, Southern Medical University, Foshan
,
X. Y. Liang
1   Gastroenterology, Nanhai Hospital, Southern Medical University, Foshan
,
H. He
2   Obstetrics and Gynecology, Nanhai Hospital, Southern Medical University, Foshan
,
H. Huang
1   Gastroenterology, Nanhai Hospital, Southern Medical University, Foshan
,
L. P. Jia
1   Gastroenterology, Nanhai Hospital, Southern Medical University, Foshan
› Author Affiliations
Further Information

Publication History

13 November 2012

16 March 2013

Publication Date:
09 July 2013 (online)

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Abstract

Objective: The aim of this study was to evaluate the clinical features and treatment responses of eosinophilic gastroenteritis (EG) with ascites.

Methods: Clinical data were collected on 6 EG patients with ascites from 2000 to 2012.

Results: Six patients were included in this study, ranging in age from 15 to 30 years. Most had an acute onset (5/6). The clinical manifestations included abdominal pain (5/6), vomiting (4/6), and diarrhea (3/6). The absolute values and percentages of peripheral blood eosinophils (Eos) were significantly elevated in all patients. Erosive or ulcerative lesions were found on endoscopic examination of all patients (6/6). Eosinophilic inflitration was confirmed by endoscopic biopsies (4/6). Ultrasound or abdominal CT showed gastrointestinal wall thickening and peritoneal effusion (6/6). Ascites from the patients were analyzed. Eos were found in ascites by pathological examination in the majority (5/6). The symptoms and peripheral eosinophilia responded to glucocorticoid treatment (p < 0.05). All the patients had good outcomes. One female patient had a relapse, which responded to re-administration of glucocorticoid treatment.

Conclusions: EG with ascites is more common in young patients, often presenting with non-specific symptoms. Typical clinical manifestations include acute onset, abdominal pain, and ascites. Eos in ascites and peripheral blood are the main diagnostic clues. Ultrasound and CT examinations are important to support the diagnosis of EG, and endoscopic biopsies can help to establish the diagnosis. Treatment with glucocorticoids is effective.

Zusammenfassung

Ziel: Evaluierung der klinischen Präsentation und Behandlungsergebnisse bei eosinophiler Gastroenteritis (EG) mit begleitendem Aszites.

Methoden: Von 2000 bis 2012 wurden klinische Daten von 6 EG-Patienten mit Aszites gesammelt.

Ergebnisse: Sechs Patienten im Alter von 15 - 30 Jahren wurden in die Studie eingeschlossen. Bei den meisten Patienten (5/6) traten die Symptome akut auf. Klinisch manifestierten sich abdominelle Schmerzen (5/6), Erbrechen (4/6), und Diarrhöe (3/6). Bei allen Patienten waren die absoluten und prozentualen Werte der peripheren Eosinophilen in Blut (Eos) signifikant erhöht. Die endoskopische Untersuchung ergab bei allen Patienten (6/6) erosive oder ulzerative Läsionen. Die endoskopische Biopsie bestätigte die Infiltration mit Eosinophilen (4/6). Eine Sonografie oder CT des Abdomens zeigte eine Wandverdickung im Magen-Darm-Trakt und peritoneale Flüssigkeitsansammlungen (6/6). Aszites der Patienten wurde untersucht. Die pathologische Untersuchung zeigte bei der Mehrheit der Patienten (5/6) das Vorhandensein von Eosinophilen. Die klinischen Symptome sowie die periphere Eosinophilie sprachen auf die Behandlung mit Glukokortikoiden an (p < 0,05). Alle Patienten zeigten ein gutes Behandlungsergebnis. Eine Patientin erlitt einen Rückfall, der jedoch auf erneute Gabe von Glukokortikoiden ansprach.

Schlussfolgerungen: EG mit Aszites tritt bei jungen Patienten häufiger auf, oft mit unspezifischen Symptomen. Typische klinische Manifestationen sind akutes Auftreten der Symptome, abdominelle Schmerzen und Aszites. Das Vorhandensein von Eosinophilen in Aszites und peripherem Blut sind die wesentlichen dignostischen Hinweise. Sonografie und CT Untersuchungen sind wichtig, um die Diagnose der EG zu stützen und eine endoskopische Biopsie kann bei der Diagnosestellung hilfreich sein. Die Behandlung mit Glukokortikoiden hat sich als wirksam erwiesen.

Key words

gastritis - infectious colitis - maldigestion - eosinophilic gastroenteritis - ascites - pathology - glucocorticoids

Schlüsselwörter

Gastritis - infektiöse Kolitis - Maldigestion - eosinophile Gastroenteritis - Aszites - Pathologie - Glukokortikoide
 

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