Allergy Asthma Respir Dis.  2015 May;3(3):228-231. 10.4168/aard.2015.3.3.228.

Eosinophilic gastroenteritis which leads to mal-absorption and anemia associated with food allergies

• Kim YG
• Lim ES
• Kim HJ
• Choi WS
• Hong GN
• Shin YS

• KMID: 2168495
• DOI: http://doi.org/10.4168/aard.2015.3.3.228

Abstract

Eosinophilic gastroenteritis (EG) is a rare disease characterized by massive eosinophilic infiltration of gastrointestinal tissue, peripheral eosinophilia, and nonspecific gastrointestinal symptoms. The mucosal type of EG commonly presented with malabsorption and anemia. However, the role of food allergy as a stimulus to EG has not yet been clearly defined. A 27-year-old man was referred to the Emergency Department with dyspepsia and leg swelling. The initial laboratory test should as follows: hemoglobin level, 6.4 g/dL; white blood cell count, 7,400/microL with 24.4% of eosinophil fraction; serum total protein, 3.9 g/dL; albumin level, 2.8 g/dL. Gastric endoscopy ruled out gastrointestinal bleeding showed multiple nodular raised lesions on the gastric antrum, which revealed increased eosinophilic infiltration (above 100/high power field). He had experienced nausea whenever eating beef, porks or fish. High serum specific IgE levels to offending foods (beef, 0.82 kU/L; pork, 0.83 kU/L; egg white, 0.40 kU/L; egg yolk, 0.54 kU/L; milk, 0.81 kU/L) were noted. He was instructed strictly to avoid food allergens with oral prednisolone therapy. Approximately 6 months after offending food restriction, the eosinophil count fell down to 400/microL, the hemoglobin level was returned to 11.5 g/dL and the serum albumin level was increased to 4.1 g/dL. We report a case of EG caused by multiple food allergy which leads to malabsorption and iron-deficiency anemia.

Keyword

Eosinophilic enteropathy; Malabsorption syndromes; Food hypersensitivity

MeSH Terms

Adult
Allergens
Anemia*
Anemia, Iron-Deficiency
Dyspepsia
Eating
Egg White
Egg Yolk
Emergency Service, Hospital
Endoscopy
Eosinophilia
Eosinophils*
Food Hypersensitivity*
Gastroenteritis*
Hemorrhage
Humans
Immunoglobulin E
Leg
Leukocyte Count
Malabsorption Syndromes
Milk
Nausea
Prednisolone
Pyloric Antrum
Rare Diseases
Serum Albumin
Allergens
Immunoglobulin E
Prednisolone
Serum Albumin

Figure

• 

  Fig. 1 Hematoxylin and eosin stain shows a marked eosinophilic infiltration of mucosa (A, ×100; B, ×400).

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