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695 Eosinophilic Gastrointestinal Disease in Children: Diverse Clinical Manifestations
  1. HH Shih1,
  2. KB Tsai2
  1. 1Kaohsiung Municipal Hsiao-Kang Hospital
  2. 2Dept. of Pathology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung City, Taiwan R.O.C.

Abstract

Background Clinical manifestations of eosinophilic gastrointestinal diseases (EGIDs) varies a lot in Children. The diagnosis relies on practitian’s experience and characteristic pathological features.

Methods A retrospective chart review was conducted of pediatric patients (younger than 18 years old) diagnosed with EGIDs by histopathology proven between 1998 and 2012. Clinical presentations, laboratory data, endoscopic and histopathologic findings were analyzed.

Results Eleven pediatric patients (5 boys and 6 girls) were identified and recruited into the study. There were 8 cases (72%) with eosinophilic gastroenteritis (EGE) and three cases (33%) with eosinophilic colitis (EoC). The clinical features of EGE included abdominal pain (6/8, 75%), vomiting (5/8, 62.5%), diarrhea (3/8, 37.5%), peripheral eosinophilia >500 cells/microL (0/6, 0%), elevated IgE (4/8, 50%), documented specific food IgE (3/7, 43%). One infant was presented as protein-losing enteropathy. Swollen pyloric ring, edematous duodenal bulb hinted the diagnosis on endoscopy. One patient received appendectomy because of acute abdomen. All patients’ acute symptoms got improved after anti-histamine, probiotics, or even short-course steroid. The clinical manifestations of EoC included bloody stool (3/3, 100%), diarrhea (2/3, 66%), abdominal colic (1/3, 33%), elevated IgE levels (2/3, 66%), peripheral eosinophilia >500 cells/microL(1/3, 33%).

Conclusion EGIDs in children vary a lot among different age groups and clinical manifestations. Endoscopic exam with biopsy should be considered for unexplained gastrointestinal symptoms which may persist for weeks and lack of infectious etiology. Prompt diagnosis need highly suspicion of practitioners and could avoid unnecessary operation and/or delayed treatment.

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