title: Eosinophilic gastroenteritis associated with giant folds.
abstract: We describe a 54-year-old man who presented with right subcostal pain. Minocycline had been prescribed to treat pruritus, and the symptoms resolved. Subsequently, the patient consulted a local physician because of right subcostal pain. Giant folds were found in the greater curvature of the gastric body, and he was referred to the Department of Gastroenterology, Kitasato University East Hospital. Upper gastrointestinal endoscopy revealed markedly enlarged folds in the greater curvature of the stomach, with redness and edematous mucosa in the lesser curvature. Biopsy showed marked inflammatory cell infiltration (mainly eosinophils), but no atypical cells. Blood tests showed marked eosinophilia and elevated immunoglobulin E levels in the serum. The results of various allergic examinations were negative, but the clinical course suggested drug-induced eosinophilic gastroenteritis, and treatment was started. Minocycline was withdrawn without adequate resolution of symptoms. Because the leukocyte and eosinophil counts continued to increase, the patient was given suplatast, an anti-allergic agent. The symptoms and hematological values improved promptly. The patient recovered uneventfully, with no recurrence.
authors.affiliation: Department of Gastroenterology, Kitasato University East Hospital, Kanagawa, Japan. k.ishido@kitasato-u.ac.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishido
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanabe
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Higuchi
authors.forename: Tohru
authors.initials: T
authors.lastname: Sasaki
authors.forename: Chikatoshi
authors.initials: C
authors.lastname: Katada
authors.forename: Mizutomo
authors.initials: M
authors.lastname: Azuma
authors.forename: Wasaburo
authors.initials: W
authors.lastname: Koizumi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Saigenji
authors.forename: Shiro
authors.initials: S
authors.lastname: Niiyama
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Mikami
mesh_terms: D018926:Anti-Allergic Agents / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001190:Arylsulfonates / Q000627:therapeutic use; D001706:Biopsy; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D004802:Eosinophilia / Q000139:chemically induced* / Q000175:diagnosis* / Q000188:drug therapy; D005759:Gastroenteritis / Q000139:chemically induced* / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000009:adverse effects*; D013452:Sulfonium Compounds / Q000627:therapeutic use
chemical_list: D018926:Anti-Allergic Agents; D000900:Anti-Bacterial Agents; D001190:Arylsulfonates; D013452:Sulfonium Compounds; D007073:Immunoglobulin E; C073028:suplatast tosilate; D008911:Minocycline