2019 Volume 61 Issue 3 Pages 266-272
A 44-year-old man on oral steroid therapy for eosinophilic gastrointestinal disorder (EGID) was admitted to our hospital with persistence of severe abdominal pain, watery diarrhea, lumbago, and noncardiac chest pain after taking nonsteroidal anti-inflammatory drugs (NSAIDs). He had suffered from almost the same symptoms while taking NSAIDs twice within the previous 18 months before admission. Over the previous 10 months before admission, he had been treated with oral prednisolone for EGID at a nearby clinic because of the presence of eosinophilia. At admission, his serum levels of amylase and lipase were found to be elevated. Computed tomography and ultrasonography showed a thickened small intestinal wall. Esophagogastroduodenoscopy revealed severe edematous change with whitish turbidity in the entire esophagus. Biopsy examination showed infiltration of numerous eosinophils in the esophageal epithelium. He received 30mg of prednisolone intravenously, and his symptoms dramatically disappeared. Although he seemed to be in the active phase of his EGID at first glance, his clinical episodes had been consistent with aspirin intolerance. In conclusion, we describe a rare case of aspirin intolerance presenting with eosinophilic esophagitis, gastroenteritis and pancreatitis.
