title: Eosinophilic Gastroenteritis: An Underdiagnosed Condition.
abstract: Eosinophilic gastroenteritis (EOGE) is a rare idiopathic disease characterized by eosinophil-predominant inflammation of the stomach and/or intestines. Our aims are to determine the epidemiology, clinical features and outcomes of EOGE cases in a tertiary-care hospital.
  
  
  
  Retrospective cohort study of patients with gastrointestinal eosinophilic infiltration from 2004 through 2014. All relevant specimens were reviewed by an expert pathologist. Significant eosinophilic infiltrate was defined as >25 eosinophils/HPF in the stomach or small intestine and >50 eosinophils/HPF in the colon.
  
  
  
  Three hundred and sixty-one charts were reviewed and 13 EOGE cases were identified, including nine adults and four pediatric cases. The majority (78 %) of adult cases were females. Clinical presentation was variable; most patients (62 %) had abdominal pain, followed by diarrhea (31 %) and nausea/vomiting (31 %). Atopy and food allergies were present in 54 and 38 % of patients, respectively. Weight loss and failure to thrive were present only in pediatric cases (50 vs 0 %; P = .01). Most EOGE cases (69 %) had peripheral eosinophilia, which was more prominent in patients with ascites compared to patients without ascites (37.3 ± 25.4 vs 9.3 ± 5.4 %; P = .01). Among patients who had long-term follow-up; 30 % had spontaneous remission, 60 % responded to steroids and/or restriction diet, and 10 % had refractory disease.
  
  
  
  EOGE is an underdiagnosed condition. In contrast to eosinophilic esophagitis; the disease might be female-predominant in adults. High index of clinical suspicion is required for diagnosis. Further studies about the long-term outcomes and the efficacy of restriction diet in adult patients are required.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, MSC10-5550, University of New Mexico, Albuquerque, NM, USA. talhmoud@salud.unm.edu.
authors.forename: Tarik
authors.initials: T
authors.lastname: Alhmoud
authors.affiliation: Department of Pathology, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Joshua Anspach
authors.initials: JA
authors.lastname: Hanson
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, MSC10-5550, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Gulshan
authors.initials: G
authors.lastname: Parasher
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001201:Ascites / Q000209:etiology; D001213:Asian; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D003967:Diarrhea / Q000209:etiology; D004035:Diet Therapy; D004751:Enteritis / Q000150:complications / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D004802:Eosinophilia / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D005183:Failure to Thrive / Q000209:etiology; D005512:Food Hypersensitivity / Q000453:epidemiology*; D005756:Gastritis / Q000150:complications / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D006630:Hispanic or Latino; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology; D007198:Indians, North American; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D009516:New Mexico / Q000453:epidemiology; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology; D015431:Weight Loss; D044465:White People
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Eosinophilic colitis; Eosinophilic enteritis; Eosinophilic esophagitis; Eosinophilic gastroenteritis