Eosinophilic colitis

Eosinophilic colitis （EC） is a rare form of primary eosinophilic gastrointestinal disease with a bimodal peak of prevalence in neonates and young adults. EC remains a little understood condition in contrast to the increasingly recognized eosinophilic esophagitis. Clinical presentation of EC is highly variable according to mucosal, transmural, or serosal predominance of inflammation. EC has a broad differential diagnosis because colon tissue eosinophilia often occurs in parasitic infection, drug-induced allergic reactions, inflammatory bowel disease, and various connective tissue disorders, which require thorough searching for secondary causes that may be specifically treated with antibiotics or dietary and drug elimination. Like eosinophilic gastrointestinal disease involving other segments of the gastrointestinal tract, EC responds very well to steroids that may be spared by using antihistamines, leukotriene inhibitors and biologics.     

Eosinophilic colitis

Eosinophilic gastroenteritis, a condition of unknown etiology, has frequently been reported involving the stomach and small bowel. The colon is rarely cited as a site for the condition; however, a review of the literature reveals over 20 cases (including ours). The findings indicate that the colon is now a recognized, but rare, site of involvement and that the condition can be diagnosed via the colonoscope. No clear-cut etiology can be defined, but the presence of allergy (33 percent) and of the herring worm (two cases) is noted.     

嗜酸性粒细胞性消化道炎

原发性嗜酸性粒细胞性消化道炎（eosinophilic gastrointestinal disease,EGID）是以消化道嗜酸性粒细胞异常浸润为特征的炎症性疾病。该病可以累及消化道全长或某一部分,包括嗜酸性粒细胞性食管炎（eosinophilicesophagitis,EE）、胃炎、胃肠炎（eosinophilic gastroenteritis,EG）、小肠炎、结肠炎及直肠炎。在过去的几十年中,文献报道的发病率逐渐增高。其病因及发病机制并不清楚,大多数研究结果都提示,吸入和食物过敏反应可能诱发该病的发作。其临床主要表现为各种消化道症状,无特异性,诊断标准未得到一致公认,多强调以病理为主的综合诊断,同时要除外其他继发性消化道嗜酸性粒细胞增多疾病。治疗以控制饮食和糖皮质激素为主,近年出现针对发病机制的生物制剂治疗,但尚缺少充分的循证医学依据。     

Eosinophilic colitis: A clinical review

Eosinophilic colitis is a rare entity characterized by the presence of a high eosinophilic infiltrate into the colonic wall in symptomatic patients, more often presenting with abdominal pain or diarrhea. These characteristics distinguish eosinophilic colitis from primary colonic eosinophilia, in which patients are asymptomatic. Primary colonic eosinophilia does not need any therapy, while eosinophilic colitis requires a strict treatment, similar to that of the more codified chronic intestinal inflammatory diseases. To date the lack of codified guidelines regarding the diagnostic criteria and the eosinophil threshold values for each colonic segment are the main diagnostic challenge for eosinophilic colitis. In addition, eosinophilic colitis is a diagnosis of exclusion, once all other causes of colonic eosinophilia (food allergens, infections, drugs, etc.) have been excluded. Several treatment options are available for eosinophilic colitis, although the evidence for most of them is limited to case reports and small case series.We examine the epidemiology, etiology, pathophysiology, diagnostic criteria and therapeutic options of eosinophilic colitis reporting recent evidence from the current literature.     

Eosinophilic fasciitis and eosinophilic colitis: a rare association

SIR, Although eosinophilic fasciitis (EF) was originally consideredto be a disease predominantly localized to the fascia, severalcase reports have subsequently reported other manifestations[1–7]. Aplastic anaemia, haemolytic anaemia, thrombocytopenia,lymphoproliferative disorders, thyroiditis, pulmonary fibrosis,Sjögren's syndrome, Raynaud's phenomenon, myositis, mediumvessel vasculitis, pericarditis, colitis and glomerulonephritisare some of the manifestations that have been reported in patientswith EF. To our knowledge, the association of eosinophilic colitis(EC) and EF has been reported only once before [6]. Here, wedescribe an additional patient with EF who developed EC. A 38-yr-old previously fit and healthy man initially presentedto the general physicians in December 2000 with a 2-month history