Clinical Manifestations and Treatment Outcomes of Eosinophilic Gastroenteritis in Children

다국어 초록 (Multilingual Abstract)

Purpose: The aim of the present study was to investigate the clinical features and outcome of eosinophilic gastro-enteritis (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 out-comes 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, sub-serosal, 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 treat-ment, and 4 (21.1%) showed no response to steroids. Two patients who were resistant to steroids underwent ther-apeutic 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 pa-tients showed a relapse or steroid resistance.

참고문헌 (Reference)

1 Schwartz DA, "Use of montelukast as steroid-sparing agent for recurrent eosinophilic gastroenteritis" 46 : 1787-1790, 2001

2 Lee MS, "Serum IgE standardized for age in Korean children and its diagnostic reliability in childhood asthma" 39 : 397-403, 1996

3 Yan BM, "Primary eosinophilic disorders of the gastrointestinal tract" 58 : 721-732, 2009

4 Pineton de Chambrun G, "Natural history of eosinophilic gastroenteritis" 9 : 950-956, 2011

5 Yamaguchi Y, "Highly purified murine interleukin 5 (IL-5) stimulates eosinophil function and prolongs in vitro survival. IL-5 as an eosinophil chemotactic factor" 167 : 1737-1742, 1988

6 Whitington PF, "Eosinophilic gastroenteropathy in childhood" 7 : 379-385, 1988

7 Redondo-Cerezo E, "Eosinophilic gastroenteritis:our recent experience: one-year experience of atypical onset of an uncommon disease" 36 : 1358-1360, 2001

8 Chen MJ, "Eosinophilic gastroenteritis: clinical experience with 15 patients" 9 : 2813-2816, 2003

9 Méndez-Sánchez N, "Eosinophilic gastroenteritis: a review" 52 : 2904-2911, 2007

10 Talley NJ, "Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues" 31 : 54-58, 1990

11 Lee CM, "Eosinophilic gastroenteritis: 10 years experience" 88 : 70-74, 1993

12 Cello JP, "Eosinophilic gastroenteritis--a complex disease entity" 67 : 1097-1104, 1979

13 Yamada Y, "Eosinophilic gastroenteritis treated with a multiple-food elimination diet" 63 (63): 53-56, 2014

14 Yun MY, "Eosinophilic gastroenteritis presenting as small bowel obstruction: a case report and review of the literature" 13 : 1758-1760, 2007

15 Khan S, "Eosinophilic gastroenteritis masquerading as pyloric stenosis" 39 : 55-57, 2000

16 Quack I, "Eosinophilic gastroenteritis in a young girl--long term remission under Montelukast" 5 : 24-, 2005

17 Khan S, "Eosinophilic gastroenteritis" 19 : 177-198, 2005

18 Kelly KJ, "Eosinophilic gastroenteritis" 30 (30): S28-35, 2000

19 Klein NC, "Eosinophilic gastroenteritis" 49 : 299-319, 1970

20 Pineton de Chambrun G, "Eosinophilic enteritis" 33 : 183-189, 2015

21 Lucendo AJ, "Efficacy of dietary treatment for inducing disease remission in eosinophilic gastroenteritis" 61 : 56-64, 2015

22 Kalantar SJ, "Dyspepsia due to eosinophilic gastroenteritis" 42 : 2327-2332, 1997

23 Tien FM, "Clinical features and treatment responses of children with eosinophilic gastroenteritis" 52 : 272-278, 2011

24 DeBrosse CW, "Allergy and eosinophil-associated gastrointestinal disorders (EGID)" 20 : 703-708, 2008

25 Lowichik A, "A quantitative evaluation of mucosal eosinophils in the pediatric gastrointestinal tract" 9 : 110-114, 1996