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Original ArticleOpen Access
Eosinophilic Gastrointestinal Disease: Analysis of Sixteen Cases from Ten Years Experience in Thailand
Vithayasai N 
,
Jennuvat S ,
Lertsatit A
,
Jennuvat S ,
Lertsatit A Objective: To study eosinophilic gastrointestinal disease (EGIDs) in children concerning the clinical presentations, diagnostic
methods and results of treatment.
Material and Method: A retrospective study of EGIDs was done from January 2000 to December 2009. All patients
diagnosed as EGIDs according to gastrointestinal symptoms combined with eosinophilic infiltration in mucosal, muscular
or serosal layer of involvement. Exclusion of extraintestinal eosinophilic involvement and parasitic infestations were done.
Analysis of clinical presentations, diagnostic methods and results of treatment were reviewed.
Results: Sixteen children fulfilled criteria of EGIDs. Mucosal type was the most common finding type (12 out of 16 cases)
(75%). Muscular and serosal type was found in equal numbers (2 of each in 16 cases) (12.5% each). Ages ranged from 6
months to 13 years. The male: female ratio was 1: 1.2. Abdominal pain was the most common presenting symptom followed
by diarrhea. Allergic history was detected in 68.75% of all patients. Peripheral eosinophilia was found in only 37.5% of all
cases. Radiographic findings showed non-specific findings. Endoscopy was performed in 14 out of 16 cases (87.5%).
Lymphoid hyperplasia was the most common endoscopic finding especially in mucosal type. Eosinophil (more than 20 per
high power field) was found from biopsied tissues obtained from the esophagus, stomach, colon or from ascitic fluid.
Prednisolone was used in 13 out of 16 cases with satisfactory results in 11 cases. The two resisted cases responded to
ketotifen in one and the other in combination with montelukast. One out of 16 cases subsided with only proton pump
inhibitor. The last two cases improved by allergic food elimination.
Conclusion: Eosinophilic gastrointestinal disease in children presents with varieties of gastrointestinal symptoms. Biopsied
tissues or ascitic fluid are required to demonstrate significant eosinophilic infiltration or presence of eosinophil. Allergic
history seems to play an important role in more than half of the patients. Specific dietary elimination is the most important
treatment in allergic cases. Corticosteroid is the treatment of choice in the non-allergic group or for those who did not
improve with food elimination.
Keywords: Eosinophil, Eosinophilic gastrointestinal disease
methods and results of treatment.
Material and Method: A retrospective study of EGIDs was done from January 2000 to December 2009. All patients
diagnosed as EGIDs according to gastrointestinal symptoms combined with eosinophilic infiltration in mucosal, muscular
or serosal layer of involvement. Exclusion of extraintestinal eosinophilic involvement and parasitic infestations were done.
Analysis of clinical presentations, diagnostic methods and results of treatment were reviewed.
Results: Sixteen children fulfilled criteria of EGIDs. Mucosal type was the most common finding type (12 out of 16 cases)
(75%). Muscular and serosal type was found in equal numbers (2 of each in 16 cases) (12.5% each). Ages ranged from 6
months to 13 years. The male: female ratio was 1: 1.2. Abdominal pain was the most common presenting symptom followed
by diarrhea. Allergic history was detected in 68.75% of all patients. Peripheral eosinophilia was found in only 37.5% of all
cases. Radiographic findings showed non-specific findings. Endoscopy was performed in 14 out of 16 cases (87.5%).
Lymphoid hyperplasia was the most common endoscopic finding especially in mucosal type. Eosinophil (more than 20 per
high power field) was found from biopsied tissues obtained from the esophagus, stomach, colon or from ascitic fluid.
Prednisolone was used in 13 out of 16 cases with satisfactory results in 11 cases. The two resisted cases responded to
ketotifen in one and the other in combination with montelukast. One out of 16 cases subsided with only proton pump
inhibitor. The last two cases improved by allergic food elimination.
Conclusion: Eosinophilic gastrointestinal disease in children presents with varieties of gastrointestinal symptoms. Biopsied
tissues or ascitic fluid are required to demonstrate significant eosinophilic infiltration or presence of eosinophil. Allergic
history seems to play an important role in more than half of the patients. Specific dietary elimination is the most important
treatment in allergic cases. Corticosteroid is the treatment of choice in the non-allergic group or for those who did not
improve with food elimination.
Keywords: Eosinophil, Eosinophilic gastrointestinal disease
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