title: Mucosal-type eosinophilic gastroenteritis in Thailand: 12-year retrospective study.
abstract: OBJECTIVE
  To evaluate the clinical features and natural course of disease among patients with mucosal-type eosinophilic gastroenteritis in Thailand.
  
  
  METHODS
  The present study was conducted by retrospectively searching for the ICD-10 code for eosinophilic gastroenteritis (EGE) among medical records for the period 2001-2012. Clinical and pathological specimens were reviewed using the same diagnostic criteria. Appropriate tests were conducted to exclude other secondary causes of EGE. All patients had to have either received empirical treatment for parasitic infections or were tested for parasites in the stool. After the diagnosis had been established, each patient received 30-40 mg/day of oral prednisoloneforfour weeks, which was tapered down as clinical status improved. All patients were followed up by monitoring clinical symptoms and relevant laboratory findings. Patients who did not maintain follow-up appointments were contacted by telephone and asked about their clinical symptoms.
  
  
  RESULTS
  Seventeen patients with a diagnosis of mucosal-type E (6 male, 11 female, M:F ratio 1:1.83) were found. Mean age at the time of presentation was 52.5 +/- 13.04 years. Four patients (23.5%) had either allergic or atopic conditions. Chronic diarrhea and weight loss were the most common initial presentation in 16 patients (94.1%). Microscopically and macroscopically, bloody diarrhea was observed in 13 cases (76.5%). Four patients were found to have protein-losing enteropathy. Peripheral eosinophilia was found in 10 patients (58.8%) with absolute eosinophil counts between 744 and 23,550 cells/mm3. Eight of these had an absolute eosinophil count in the hypereosinophilic range (> 1,500 cells/mm3). All patients treated with prednisolone treatment showed symptomatic improvement within four weeks. One patient's symptom resolved spontaneously, without treatment. Thirteen patients relapsed during the tapering-off of prednisolone. Seven patients showed complete remission. Three patients subsequently developed cancer (lung, breast, and bladder) after EGE was diagnosed.
  
  
  CONCLUSIONS
  EGE, although uncommon, is present in Thailand, where parasitic infections continue to be a significant public-health problem.
authors.affiliation: Siriraj Hospital, Mahidol University, Bangkok, Thailand. wuttiporn.manatsathit@stjohn.org
authors.forename: Wuttiporn
authors.initials: W
authors.lastname: Manatsathit
authors.forename: Radsamee
authors.initials: R
authors.lastname: Sermsathanasawadi
authors.forename: Ananya
authors.initials: A
authors.lastname: Pongpaiboon
authors.forename: Supot
authors.initials: S
authors.lastname: Pongprasobchai
mesh_terms: D000328:Adult; D000368:Aged; D004751:Enteritis / Q000145:classification; D004802:Eosinophilia / Q000145:classification; D005260:Female; D005753:Gastric Mucosa; D005756:Gastritis / Q000145:classification; D005759:Gastroenteritis / Q000145:classification; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013785:Thailand; D013997:Time Factors