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2015 ; 22
(3
): 183-5
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Eosinophilic ascites: A case report and literature review
#MMPMID26392801
Alsulaiman RM
J Family Community Med
2015[Sep]; 22
(3
): 183-5
PMID26392801
show ga
Eosinophilic gastroenteritis is a rare gastrointestinal (GI) disorder
characterized by nonspecific GI symptoms, peripheral eosinophilia, and
eosinophilic infiltration of the intestinal wall. The disorder is classified into
mucosal, muscular, and sub-serosal types, depending on the clinical picture and
the depth of eosinophilic infiltration within the GI wall. Sub-serosal disease,
which is complicated by ascites, usually results in the most severe clinical form
of eosinophilic gastroenteritis and requires early corticosteroid therapy. In
such cases, a favorable outcome can be achieved after a short course of
corticosteroids. We present the case of a 28-year-old female with diffuse
abdominal pain and distention for 2 weeks. Her physical examination was
significant for moderate ascites. Initial work-up demonstrated severe peripheral
blood eosinophilia, normal liver function tests, and elevated serum
immunoglobulin E (IgE). Upper endoscopy, colonoscopy showed a thickening of the
stomach and colon, and biopsies showed marked eosinophilic infiltration of the
mucosa. Ascitic fluid analysis showed significant eosinophilia. Subsequent
treatment with oral prednisone resulted in the normalization of laboratory and
radiologic abnormalities 45 days after the start of the treatment. Despite its
rarity, eosinophilic gastroenteritis needs to be recognized by the clinician
because the disease is treatable, and timely diagnosis and initiation of
treatment could be of major importance.
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