Eosinophilic gastroenteritis: a challenge to diagnose and treat.
The patient presented with bloody diarrhoea, and crampy abdominal pains. She was diagnosed with eosinophilic gastroenteritis (EGE) after the finding of persistently high peripheral eosinophil counts and histology of endoscopic biopsies. She responded to steroids but became dependent on it and her symptoms recurred on steroid tapering. There was little improvement with alternative treatment such as budesonides, azathioprine and montelukast. Surprisingly her symptoms improved significantly after she was treated with clarithromycin for chest infection and she was continued on clarithromycin. Her eosinophil counts fell dramatically and follow-up CT (thorax, abdomen and pelvic) scan showed the mucosal thickening had improved. She became completely free of the symptoms since she was on clarithromycin and her eosinophils counts fell within the normal range during the follow-up.
Department of Medicine, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.
Naw April
NA
Phaw
Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.
Her Hsin
HH
Tsai
D000085:Acetates / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D001706:Biopsy; D019819:Budesonide / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use*; D003521:Cyclopropanes; D004724:Endoscopy; D004751:Enteritis / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D004802:Eosinophilia / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D004804:Eosinophils; D005260:Female; D005756:Gastritis / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D005759:Gastroenteritis / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007958:Leukocyte Count; D018942:Macrolides / Q000627:therapeutic use; D009092:Mucous Membrane / Q000473:pathology; D011804:Quinolines / Q000627:therapeutic use; D013440:Sulfides
D000085:Acetates; D000900:Anti-Bacterial Agents; D003521:Cyclopropanes; D018942:Macrolides; D011804:Quinolines; D013440:Sulfides; D019819:Budesonide; D017291:Clarithromycin; C093875:montelukast; D001379:Azathioprine