EOSINOPHILIC GASTROENTERITIS WITH HYPEREOSINOPHILIC ASCITES : REPORT OF TWO CASES

Abstract

Two cases of eosinophilic gastroenteritis with hypereosinophilic ascites were reported. Case 1: A 27 year-old woman was admitted to the Iwate Prefectual Hukuoka Hospital complaining of recurrent epigastric pain, nausea and diarrhea after delivery and she had a past history of cold urticaria and gastritis. Examination of the peripheral blood disclosed 39, 200 of white blood cells with 79% eosinophils and there were many eosinophils in the ascites. Panendoscopy revealed multiple spotty and patcy redness in the gastric angulus and the lower gastric body, and laparoscopy revealed multiple redness in the serosa of the stomach and small bowel. The infiltration of the eosinophils was seen in the gastric mucosa of the biopsy specimens. After administration of predonisolone the ascites disappeared and the subjective symptoms were improved. Case 2 : A 37-year-old woman was admitted to the Iwate Medical University Hospital complaining of abdominal pain and she had a past history of food allergy, disorder of bowel movements and gastritis. At admission there were many eosinophils in the ascites. Examination of the peripheral blood disclosed normal count but eosinophils increased to 11.1%. Panendoscopy revealed normal findings of the stomach and duodenum but infiltration of eosinophils was seen in both gastric and duodenal mucosa. Ascites disappeared and the subjective symptoms were improved without specific therapy. The diagnosis of eosinophilic gastroenteritis is comparatively easy with history of allergy, subjective symptoms and an increase of eosinophils in the peripheral blood and GI tract mucosa. And observation of the serosa of the GI tract by laparoscopy is useful. Administration of steroid hormone may not always be needed and some cases of eosinophilic gastroenteritis with hypereosinophilic ascites may improve spontaneously without specific therapy.