• Journal of Gastric Cancer
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• v.5 no.1
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• pp.47-51
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• 2005

Eosinophilic gastroenteritis is a rare clinicopathologic entity of unknown etiology with a variety of digestive symptoms. The pathogenesis is poorly understood. Diagnostic criteria include demonstration of eosinophilic infiltration of the affected bowel wall, lack of evidence of extraintestinal disease, and exclusion of various disorders that could mimic similar conditions. The disease might involve any area of the gastrointestinal tract from the esophagus to the rectum, but the stomach and the proximal small bowel are most commonly affected. The clinical features depend on which layer and site are involved. We report the case of a 59-year-old male patient with a 3-week history of post-prandial vomiting with malnutrition and weight loss. An abdominopelvic CT showed a gastric outlet obstruction with diffuse wall thickening, as with linitis plastica. Three gastrofiberscopic biopsies showed chronic gastritis. We carried out a radical total gastrectomy with D2 lymph node dissection. The pathologic report revealed a mural type eosinophilic gastritis with a marked hypertrophic scar formation at the proper muscle layer. We report this case with a brief review of the literature. (J Korean Gastric Cancer Assoc 2005;5:47-51)

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.2
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• pp.239-242
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• 2004

Eosinophilic gastroenteritis is a rare condition of unknown etiology characterized by peripheral eosinophilia, eosinophilic infiltration of the gastrointestinal tract, and gastrointestinal symptoms. Eosinophilic gastroenteritis is generally classified according to the Klain classification: predominant mucosal, muscular, and subserosal disease. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea, weight loss, anemia, protein-losing enteropathy, and intestinal perforation. Patients with muscular layer disease generally have obstructive symptoms. Subserosal eosinophilic infiltration may result in development of eosinophilic ascites. Most commonly, the stomach, duodenum, and small bowel are involved. A 13-year-old girl came to our hospital presenting with chronic, intermittent abdominal pain. She showed peripheral eosinophilia and biopsy specimen of the duodenum revealed eosinophilic infiltration of the mucosal layer. We here report a case of eosinophilic gastroenteritis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.2
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• pp.181-186
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• 2011

Eosinophilic gastroenteritis is a rare disease occurring especially in children, and shows various nonspecific presentations with infiltration of eosinophils in the gastrointestinal organs. The pathophysiology of eosinophilic gastroenteritis is not yet clearly known, but allergic reactions are suspected to be related with the disease. Eosinophilic gastroenteritis is categorized into the mucosal, muscularis and subserosal types based on which layer of the intestinal wall is involved. There are different clinical manifestations according to the involved layer. Most cases to date have responded well to steroid therapy. In this study, we diagnosed and treated a case of non-IgE-mediated, subserosal eosinophilic gastroenteritis in a child with abdominal pain, diarrhea and ascites.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.87-91
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• 2004

Herein, the case of a 5-year-old boy with cytomegalovirus-induced Menetrier's disease, with peripheral eosinophilia, presenting with abdominal pain and vomiting, followed by generalized edema, is reported. The initial laboratory findings, hypoalbuminemia and peripheral eosinophilia were noted, with no evidence of renal, hepatic, cardiac or allergic diseases. Gastrofiberscopy was performed under the suspicion of eosinophilic gastroenteritis with protein losing gastropathy. The gastrofiberscopy showed the characteristic features of giant hypertrophy of the gastric rugae, with large quantities of adherent gelatinous material on the gastric fundus and body. The histological findings revealed foveolar hyperplasia, compatible with Menetrier's disease, with massive eosinophilic infiltrations. The presence of cytomegalovirus infection was identified by serology and confirmed by urine PCR. His symptoms, gastrofiberscopic findings and peripheral eosinophilia resolved spontaneously, and he has remained well for 10 months.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.40-47
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• 2004

Purpose: A new classification of gastrointestinal food allergy was published, but the changes of terminology between previously reported terms and the new ones were in a state of disorder. This has resulted in confusion between medical communication and diagnostic and therapeutic approaches. The clinical observations of infants presenting with gastrointestinal cow milk allergy (GI-CMA) were performed, and the changes in the terminology reviewed through the published Korean literature. Methods: Between March 2003 and July 2003, data from 37 consecutive infants with GI-CMA, aged 2 weeks to 15 months, were reviewed. The challenge and elimination test of cow milk, and the endoscopic and histologic findings, were used for the seven subdivisions of GI-CMA according to a new classification on the basis of patients' ages, clinical manifestations and location of gastrointestinal lesions. Results: The 37 patients had a mean age of $5.4{\pm}4.8$ months, with those observed in 26 (70.3%) of patients being below 6 months of age. The seven final diagnoses were; cow milk protein-induced enterocolitis (CMPIE) in 12 (32.4%), cow milk protein proctitis (PROC) in 12 (32.4%), IgE-mediated (IGE) in 6 (16.2%), gastroesophageal reflux-associated cow milk allergy (GERA) in 5 (13.5%) and eosinophilic gastroenterocolitis in 2 (5.4%). CMPIE was revealed as the typical type in 7 (18.9%) and the atypical type in 5 (13.5%), and all of typical CMPIE revealed cow milk protein-induced enteropathy. The mean age at symptom onset was $4.3{\pm}0.8$ months, and for those with typical and atypical CMPIE, and PROC and GERA were $3.8{\pm}4.6$, $10.4{\pm}3.8$, $3.4{\pm}3.9$ and $7.8{\pm}5.7$ months, respectively (p<0.05). The period from onset of symptom to diagnosis was $2.4{\pm}3.3$ (0.5~12) months, with those observed in atypical CMPIE and GERA being over 3months. Although the birth weights in all patients were within the 10~90 percentile range, the body weights on diagnoses were below the 3 percentile in 48.6%; IGE 16.7%, EOS 0%, typical CMPIE 85.7%, atypical CMPIE 60.0%, PROC 25.0% and GERA 100% (p<0.05). Through the review of the Korean literature, 8 case reports and 14 original articles for GI-CMA were found. Conclusion: GI-CMA is not a rare clinical disorder and is subdivided into seven categories on the basis of the patient's age, clinical manifestations and location of the gastrointestinal lesions. The terms for GI-CMA are changing with new classifications, and careful approaches are necessary for medical communications.