Abstract
An immunohistological examination of colonic mucosa was performed on a case of hypereosinophilic syndrome presenting eosinophilic gastroenterocolitis.
A 63-year-old male was admitted to our hospital because of watery diarrhea and cerebral infarction in July, 1986. One month earlier, watery diarrhea gradually developed and had persisted every day. On admission, the patient presented right hemiplegia, remarkable eosinophilia, and a great deal of diarrhea. A biopsy of the sigmoid colonic mucosa through the gastrointestinal endoscopy revealed the accumulation of eosinophils, lymphocytes, and plasma cells in the lamina propria. Treatment with corticosteroids resulted in clinical remission, then he was discharged in October, 1986. He again entered the hospital because of seizure in August, 1987. Examination of the blood and the bone marrow showed marked eosinophilia with a normal morphological appearance. During the hospitalization the patient suffered from chronic watery diarrhea and relapsing eczema, subsequently he had become emaciated. There were no evidences of parasitic infection nor possible food allergy. An immunohistological study of the colonic mucosa showed diffuse infiltration of eosinophils accompanied with numerous IgA-containing plasma cells and a small number of IgG- or IgM-containing cells. The composition of IgA-, IgG-, an IgM-containing cells was just same as the one of normal mucosa previously reported. The pulse therapy with methylprednisolone had completely removed the infiltrated eosinophils of colonic mucosa and he was relieved from the diarrhea.
Although we could get no direct evidence that the immunological mechanism had effects on the pathogenesis of his diarrhea, his course after corticosteroid-therapy suggested that the mechanism worked at the time.
