Original Article
Clinical, endoscopic and histopathological features of eosinophilic gastroenteritis in 76 children
Sufang Yang, Min Yang, Lanlan Geng, Peiyu Chen, Gaoyang Duan, Hongli Wang, Liya Xiong, Sitang Gong
Published 2017-02-20
Cite as Chin J Dig Endosc, 2017, 34(2): 94-98. DOI: 10.3760/cma.j.issn.1007-5232.2017.02.005
Abstract
ObjectiveTo analyze the clinical, endoscopic and histopathological features of eosinophilic gastroenteritis (EG) in children.
MethodsA retrospective study of 76 children with EG was performed to analyze clinical symptoms, laboratory and imaging results, endoscopic and pathological features, status of Helicobacter pylori (H.pylori) infection, treatment and outcomes.
ResultsThe main clinical symptoms were abdominal pain in 55.3%(42/76) cases, vomiting in 39.5% (30/76) cases and hematochezia in 38.2% cases(29/76). The hemoglobin level decreased significantly in 34 cases (44.7%, 34/76). Peripheral blood eosinophil (EOS) count increased significantly in 9 cases (11.8%, 9/76) and EOS percentage increased significantly in 13 cases(17.1%, 13/76). Total serum IgE elevated in 32 cases (54.2%, 32/59). There were also 18 cases (36.7%, 18/49) positive in serum allergen-specific immunoglobulin E (sIgE) test and 25 cases (32.9%, 25/76) positive in fecal occult blood test. Among 51 cases of abdominal ultrasound examination, there were 7 cases of ascites, 4 cases of pelvis fluid and 3 cases of intestinal wall change. Endoscopic examination in 76 cases showed 63 cases (82.9%) of mucosal hyperemia/edema, 20 cases (26.3%) of ulceration, 17 cases (22.4%) of erosion, 11 cases (14.5%) of nodularity or hyperplasia and 9 cases (11.8%) of normal mucosa. The pathological examination showed mucosal inflammation with a large number of EOS infiltration(≥20 per HPF). There were 12 cases(15.8%, 12/76) of H. pylori infection. Among the 76 cases, clinical symptoms improved significantly in 74 patients after treatment with dietary allergen avoidance, anti-allergy medications, antacids, montelukast and corticosteroid, and the total efficacy was 97.4%. The efficacy of dietary allergen avoidance, anti-allergy medications, antacids and montelukast was 93.8%(61/65). The efficacy of corticosteroid was 86.7%(13/15).
ConclusionThe clinical manifestations and endoscopic characteristics of EG in children lack specificity. In terms of diagnosis, the elevated total serum IgE and the positive sIgE test may be taken as reference for the diagnosis of EG. The definite diagnosis is based on pathological examination(EOS infiltration≥20 per HPF). While in terms of treatment, dietary allergen exclusion, anti-allergy medications, antacids and montelukast are highly effective, which can be taken as the first option. There is no need of corticosteroid as routine therapy.
Key words:
Endoscopy; Histopathology; Child; Eosinophilic gastroenteritis
Contributor Information
Sufang Yang
Department of Gastroenterology, Guangzhou Women and Children′s Medical Center, Guangzhou Medical University, Guangzhou 510623, China
Min Yang
Lanlan Geng
Peiyu Chen
Gaoyang Duan
Hongli Wang
Liya Xiong
Sitang Gong
