title: Fecal microbiota transplantation and prednisone for severe eosinophilic gastroenteritis.
abstract: Eosinophilic gastroenteritis is a rare disease of unknown etiology. It is characterized by patchy or diffuse eosinophilic infiltration of the bowel wall to a variable depth and various gastrointestinal manifestations. We describe a case of severe eosinophilic gastroenteritis presenting as frequent bowel obstruction and diarrhea in a 35-year-old man. The patient was misdiagnosed and underwent surgery because of intestinal obstruction when he was first admitted to a local hospital. Then he was misdiagnosed as having Crohn's disease in another university teaching hospital. Finally, the patient asked for further treatment from our hospital because of the on-going clinical trial for treating refractory Crohn's disease by fecal microbiota transplantation. Physical examination revealed a slight distended abdomen with diffuse tenderness. Laboratory investigation showed the total number of normal leukocytes with neutrophilia as 90.5%, as well as eosinopenia, monocytopenia and lymphocytopenia. Barium radiography and sigmoidoscopy confirmed inflammatory stenosis of the sigmoid colon. We diagnosed the patient as having eosinophilic gastroenteritis by multi-examinations. The patient was treated by fecal microbiota transplantation combined with oral prednisone, and was free from gastrointestinal symptoms at the time when we reported his disease. This case highlights the importance of awareness of manifestations of a rare disease like eosinophilic gastroenteritis.
authors.affiliation: Yi-Xuan Dai, Chuan-Bing Shi, Bo-Ta Cui, Min Wang, Guo-Zhong Ji, Fa-Ming Zhang, Department of Digestive Endoscopy and Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Yi-Xuan
authors.initials: YX
authors.lastname: Dai
authors.affiliation: Yi-Xuan Dai, Chuan-Bing Shi, Bo-Ta Cui, Min Wang, Guo-Zhong Ji, Fa-Ming Zhang, Department of Digestive Endoscopy and Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Chuan-Bing
authors.initials: CB
authors.lastname: Shi
authors.affiliation: Yi-Xuan Dai, Chuan-Bing Shi, Bo-Ta Cui, Min Wang, Guo-Zhong Ji, Fa-Ming Zhang, Department of Digestive Endoscopy and Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Bo-Ta
authors.initials: BT
authors.lastname: Cui
authors.affiliation: Yi-Xuan Dai, Chuan-Bing Shi, Bo-Ta Cui, Min Wang, Guo-Zhong Ji, Fa-Ming Zhang, Department of Digestive Endoscopy and Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.affiliation: Yi-Xuan Dai, Chuan-Bing Shi, Bo-Ta Cui, Min Wang, Guo-Zhong Ji, Fa-Ming Zhang, Department of Digestive Endoscopy and Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Guo-Zhong
authors.initials: GZ
authors.lastname: Ji
authors.affiliation: Yi-Xuan Dai, Chuan-Bing Shi, Bo-Ta Cui, Min Wang, Guo-Zhong Ji, Fa-Ming Zhang, Department of Digestive Endoscopy and Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Fa-Ming
authors.initials: FM
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001691:Biological Therapy / Q000379:methods*; D001706:Biopsy; D003113:Colonoscopy; D003287:Contrast Media; D003951:Diagnostic Errors; D004751:Enteritis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D004802:Eosinophilia / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D005243:Feces / Q000382:microbiology*; D005756:Gastritis / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011241:Prednisone / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D005938:Glucocorticoids; D011241:Prednisone
keywords: Bowel obstruction; Diarrhea; Eosinophilic gastroenteritis; Fecal microbiota transplantation; Prednisone