Pediatr Gastroenterol Hepatol Nutr.  2015 Dec;18(4):253-260. 10.5223/pghn.2015.18.4.253.

Clinical Manifestations and Treatment Outcomes of Eosinophilic Gastroenteritis in Children

Affiliations
  • 1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. kojs@snu.ac.kr
  • 2Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
The aim of the present study was to investigate the clinical features and outcome of eosinophilic gastroenteritis (EGE) in children.
METHODS
Our study enrolled 24 children who were diagnosed with EGE from 1993 to 2014 at the Department of Pediatrics, Seoul National University Children's Hospital. The patients' clinical manifestations, treatments, and outcomes were reviewed from the medical records.
RESULTS
The mean age at diagnosis was 5.3 years. Most patients had gastrointestinal symptoms including diarrhea (54.2%) and abdominal pain (45.8%). Peripheral eosinophilia was present in 91.7% of the patients. Thirteen patients (54.2%) showed anemia, and 15 patients (62.5%) had hypoalbuminemia. EGE was classified as mucosal, subserosal, or muscular in 75.0%, 20.8%, and 4.2% of cases, respectively. Three patients showed gastroduodenal ulcers upon endoscopic analysis. A history of allergy was reported in 13 patients, including atopic dermatitis, allergic rhinitis, and asthma. Five patients (20.8%) improved with food restrictions. Among the 19 patients treated with steroids, 11 (57.9%) discontinued steroid treatment without subsequent relapse, 4 (21.1%) relapsed after ceasing steroid treatment, and 4 (21.1%) showed no response to steroids. Two patients who were resistant to steroids underwent therapeutic surgery. The presence of gastroduodenal ulcers was significantly associated with relapse and steroid resistance.
CONCLUSION
A high suspicion of EGE is warranted when children have nonspecific gastrointestinal symptoms and peripheral eosinophilia. Most patients improved with food restrictions or steroid treatment, although one-third of patients showed a relapse or steroid resistance.

Keyword

Eosinophils; Gastroenteritis; Ulcer; Steroids; Child

MeSH Terms

Abdominal Pain
Anemia
Asthma
Child*
Dermatitis, Atopic
Diagnosis
Diarrhea
Eosinophilia
Eosinophils*
Gastroenteritis*
Humans
Hypersensitivity
Hypoalbuminemia
Medical Records
Pediatrics
Peptic Ulcer
Recurrence
Rhinitis
Seoul
Steroids
Ulcer
Steroids
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