Pediatr Gastroenterol Hepatol Nutr.  2017 Sep;20(3):198-203. 10.5223/pghn.2017.20.3.198.

Eosinophilic Gastrointestinal Disorder Presenting as Intractable Vomiting and Ascites in a Young Girl

• Kwon JY
• Huh JS
• Je BK
• Hong KD
• Lee JH

• KMID: 2390552
• DOI: http://doi.org/10.5223/pghn.2017.20.3.198

Abstract

Eosinophilic gastrointestinal disorder (EGID) is a rare disease in children that affects the bowel wall, with eosinophilic infiltration in the absence of any other causes for eosinophilia. The etiology remains unknown, but allergies and immunological imbalance are suspected triggers. We encountered a case of serosal EGID presenting as intractable vomiting and ascites in a 9-year-old girl, after influenza virus infection. Peripheral eosinophilia was not present. The diagnosis was confirmed by biopsy of the bowel wall through laparotomy and endoscopy, and controlled by 2 courses of steroid therapy due to recurring symptoms. Influenza virus infection was assumed to play a role in the onset of EGID through a Th2 response that stimulated eosinophilic infiltration in the GI tract. We therefore report this case along with a literature review.

Keyword

Eosinophilic enteropathy; Serous membrane; Influenza A viruses

MeSH Terms

Ascites*
Biopsy
Child
Diagnosis
Endoscopy
Eosinophilia
Eosinophils*
Female*
Gastrointestinal Tract
Humans
Hypersensitivity
Influenza A virus
Laparotomy
Orthomyxoviridae
Rare Diseases
Serous Membrane
Vomiting*

Figure

• 

  Fig. 1 Abdominopelvic computed tomography showed a large amount of ascites and nodular and edematous wall thickening of small bowel loops (arrows).

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  Fig. 2 Histologic findings in a laparoscopic biopsy specimen. There was scattered eosinophilic infiltration in the (A) submucosa, (B) muscle, and (C) subserosa of the appendix (H&E, ×400).

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  Fig. 3 (A) First-look esophagogastroduodenoscopy revealed trachealization of the mid-esophagus. (B) Histologic findings of endoscopic biopsy showed marked eosinophilic infiltration in the esophagus (H&E, ×400).

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