title: Eosinophilic gastroenteritis due to cow's milk allergy presenting with acute pancreatitis.
abstract: Eosinophilic gastroenteritis (EGE) is characterized by eosinophilic infiltration of the digestive organs, most commonly of the stomach and the duodenum. Symptoms of EGE are nonspecific and include nausea, vomiting, abdominal pain, dyspepsia, malabsorption, ascites and weight loss. The various symptoms of EGE depend on its location and the depth of gastrointestinal eosinophil infiltration. We report a case presenting with acute pancreatitis caused by a milk allergy. The patient's symptoms rapidly improved after treatment with corticosteroids, and he remained symptom-free for more than 20 months by the elimination of cow's milk from his diet. Serum titers of pancreatic enzymes and total bilirubin simultaneously recovered and blood eosinophil counts normalized. The causative allergens of EGE are too various to detect; however, allergologic exams revealed that a cow's milk allergy had provoked EGE in our case. Adult-onset cow's milk allergies are rare; when seen, however, they may present severe complications such as anaphylaxis, gastroenteritis and pancreatitis. When unaccountable gastrointestinal symptoms are observed, EGE caused by food allergies should be included in the differential diagnosis.
authors.affiliation: Internal Medicine, Showa University, Tokyo, Japan. szshin@hotmail.com
authors.forename: Shintaro
authors.initials: S
authors.lastname: Suzuki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Homma
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Kurokawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsukura
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Adachi
authors.forename: Kuninobu
authors.initials: K
authors.lastname: Wakabayashi
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Nozu
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Tazaki
authors.forename: Teruaki
authors.initials: T
authors.lastname: Kimura
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsuura
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Fukuda
authors.forename: Eisuke
authors.initials: E
authors.lastname: Shiozawa
authors.forename: Masafumi
authors.initials: M
authors.lastname: Takimoto
mesh_terms: D000328:Adult; D000818:Animals; D004751:Enteritis / Q000175:diagnosis* / Q000473:pathology; D004802:Eosinophilia / Q000175:diagnosis* / Q000473:pathology; D005756:Gastritis / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D008892:Milk / Q000009:adverse effects*; D016269:Milk Hypersensitivity / Q000175:diagnosis* / Q000473:pathology; D010195:Pancreatitis / Q000175:diagnosis* / Q000473:pathology