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The Spectrum of Eosinophilic Gastroenteritis

Report of Six Pediatric Cases and Review of the Literature

Departments of Pediatrics and Adolescent Medicine, Cleveland Clinic Foundation, Cleveland Ohio

Robert Wyllie, MD

Departments of Pediatrics and Adolescent Medicine, Cleveland Clinic Foundation, Cleveland Ohio

Robert E. Petras, MD

Department of Pathology, Cleveland Clinic Foundation, Cleveland, Ohio

Maureen E. Caulfield, MD

Departments of Pediatrics and Adolescent Medicine, Cleveland Clinic Foundation, Cleveland Ohio

William M. Michener, MD

Departments of Pediatrics and Adolescent Medicine, Cleveland Clinic Foundation, Cleveland Ohio

Hugh V. Firor, MD

Departments of Pediatrics and Adolescent Medicine, Cleveland Clinic Foundation, Cleveland Ohio

Donald G. Norris, MD

Departments of Pediatrics and Adolescent Medicine, Cleveland Clinic Foundation, Cleveland Ohio

Eosinophilic gastroenteritis is an inflammatory disease of unknown etiology characterized by infiltration of the gastrointestinal tract with eosinophilic leukocytes, accompanied by varying abdominal symptoms and usually by peripheral blood eosinophilia. We report our experience with six pediatric cases presenting to the Cleveland Clinic Foundation over the past eight years. Unusual findings in our patients included ascitic fluid without eosinophilia and eosinophilic pericarditis (one patient), and eosinophilic cholecystitis (one patient). Endoscopic examination and biopsy helped to establish the diagnosis in all patients. Bone marrow aspiration supported the diagnosis by demonstrating eosinophilia and identifying reactivation of the disease, even in cases without peripheral eosinophilia. All six patients responded promptly to prednisone. Diagnosis is challenging and eosinophilic gastroenteritis may be more common than is recognized. This series of cases significantly expands the spectrum of the disease in children, and documents the usefulness of diagnostic endoscopy in this condition.

Clinical Pediatrics, Vol. 30, No. 7, 404-411 (1991)
DOI: 10.1177/000992289103000701


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