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Background. Eosinophilic gastroenteritis (EGE) is a rare disorder of unknown etiology, characterised by infiltrating eosinophils into one or more layers ofgastrointestinal tract and various gastrointestinal manifestations. Signs and symptoms are related to the layer and extent of bowel involved with eosinophilic infiltration bowel with mucosa, muscle, subserosa or all three affected. Steroid therapy remains the corner stone of treatment. Patients and methods. This paper describes a case of 70 year old male patient with eosinophilic mucosal disease of upper intestinal wall repeatedly admitted because of epigastralgias, nausea, vomiting and losing weight. Because of hypereosinophilia, a biopsy of duodenal mucosa was performed, despite the normal endoscopic appearance. Numerous eosinophilic infiltrates were histologically confirmed in mucosa and submucosa and remission followed metilprednisolon therapy. Results. After two years signs of ilness reapearred,and again metilprednisolon therapy was followed by remission which still last. Conclusions. EGE needs to be recognized by the clinician because it can masquerade as the irritable bowel syndrome. Thie diagnosis of EGE is confirmed by a characteristic biopsy. Treatment is empiric and gauged to the severity of the clinical manifestations. Izhodišča. Eozinofilni gastroenteritis (EGE) je redka bolezen, neznane etiologije, za katero je značilna infiltracija eozinofilcev v steni prebavil. Bolezenski znaki so odvisni od mesta eozinofilnih infiltratov v steni prebavilin od razširjenosti infiltratov v prebavilih. Glede na prevladujočo infiltracijo eozinofilcev v steni prebavil ločimo sluznični, mišični, subserozni in mešani tip bolezni. Bolniki in metode. Predstavljen je primer 70-letnega bolnika z eozinofilnim gastroenteritisom sluznice zgornjih prebavil, ki je bil večkrat hospitaliziran zaradi bolečin v epigastriju, slabosti, bruhanja in hujšanja. Zaradi eozinofilije je bila kljub negativnim endoskopskim preiskavam narejena biopsija sluznice dvanajstnika. V sluznici insubmukozi smo ugotovili obilen vnetni infiltrat, sestavljen iz številnih eozinofilnih granulocitov. Rezultati. Po zdravljenju z metilprednizolonom so eozinofilni infiltrati in vsi bolezenski znaki izginili. Po dveh letih je prišlo do ponovitve bolezni, ki je po kratkotrajnem zdravljenju z metilprednizolonom še vedno v remisiji. Zaključki. Na EGE moramo pomisliti pribolnikih, pri katerih s standardnimi preiskavami ne moremo opredeliti prebavnih težav. Za potrditev diagnoze je nujen histološki izvid. Zdravljenje je učinkovito in je odvisno od poteka bolezni in od kliničnih znakov. |
