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Eosinophilic Gastroenteritis as the Initial Manifestation of Hypereosinophilic Syndrome

Case report

Abstrak

Eosinophilic gastroenteritis, penyakit inflamasi yang tidak diketahui puncanya, biasanya melibatkan infiltrasi eosinophilic ke dalam perut dan usus kecil. Di sini, kami menerangkan kes gastroenteritis eosinophilic yang jarang berlaku yang melibatkan keseluruhan saluran penghadaman sebagai manifestasi sindrom hypereosinophilic. Seorang wanita berusia 22 tahun datang dengan cirit-birit, lelehan pleural, ascites dan eosinophil darah periferi yang tinggi. Spesimen najis adalah negatif untuk parasit, ova, bakteria dan kulat. Kajian endoskopi menunjukkan pangastritis dan duodenitis. Spesimen biopsi esofagus, perut, duodenum, usus kecil, dan kolon menunjukkan penyusupan eosinophilic. Diagnosa sindrom hypereosinophilic dengan gastroenteritis eosinophilic melibatkan saluran penghadaman keseluruhan telah dibuat. Oleh itu, pesakit telah dirawat dengan prednisolone. Gejala dan eosinophilia periferal sembuh dengan rawatan, dan penyiasatan radiologi menunjukkan lelehan pleura hilang selepas rawatan. Kes ini menggambarkan spektrum penyakit ini, di mana ia melibatkan saluran pencernaan keseluruhan dan ia juga menekankan kepentingan diagnostik biopsi endoskopi.

Abstract

Eosinophilic gastroenteritis, an inflammatory disease of unknown etiology, commonly involves the stomach and small intestine with eosinophilic infiltration. Here, we report an unusual case of eosinophilic gastroenteritis involving the entire digestive tract as a manifestation of hypereosinophilic syndrome (HES). A 22-year-old woman presented to us with diarrhoea, pleural effusion, ascites and marked peripheral oeosinophilia. Stool specimens were negative for parasites, ova, bacteria, and fungi. Endoscopic studies showed pangastritis and duodenitis. Biopsy specimens of the oesophagus, stomach, duodenum, ileum, and colon demonstrated oeosinophilic infiltration. A diagnosis of hypereosinophilic syndrome with eosinophilic gastroenteritis involving the entire digestive tract was made. Hence, she was treated with prednisolone. Symptoms and peripheral oeosinophilia rapidly resolved with treatment, and radiological investigations revealed resolution of effusion. This case illustrates the wide spectrum of clinical manifestation of the disease, whereby it involves the entire digestive tract and it also emphasizes the diagnostic yields of endoscopic biopsies.