Eosinophilic ascites: A diagnostic and therapeutic challenge  

作　　者：Shefali Agrawal Sandeep Vohra Sangeeta Rawat Vikas Kashyap 

机构地区：[1]Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India [2]Department of Radiology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India [3]Department of Pathology,Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India

出　　处：《World Journal of Gastrointestinal Surgery》2016年第9期656-659,共4页世界胃肠外科杂志（英文版）（电子版）

摘　　要：Eosinophilic gastroenteritis(EGE) is a rare condition characterized by eosinophilic infiltration of the gastrointestinal tract. Depending on the dominant layer of infiltration it is classified into three types namely, mucosal, muscularis and subserosal. The most uncommon variant is the subserosal type characterized by primarily subserosal disease, eosinophilic ascites and peripheral hypereosinophilia. The clinical features are non-specific with history of atopic predisposition and allergy. Endoscopic biopsy is frequently non-diagnostic due to an uninvolved gastrointestinal mucosa rendering its diagnosis a challenge. The mainstay of diagnosis is peripheral hypereosinophilia and eosinophil-rich ascitic fluid on diagnostic paracentesis. Oral steroid therapy is usually the first line of treatment with dramatic response. Due to a propensity for relapse, steroid-sparing therapy should be considered for relapses of EGE. We report a case of subserosal EGE with diagnostic clinical features and treatment response and review the current strategy in the management of eosinophilic ascites.Eosinophilic gastroenteritis (EGE) is a rare condition characterized by eosinophilic infiltration of the gastrointestinal tract. Depending on the dominant layer of infiltration it is classified into three types namely, mucosal, muscularis and subserosal. The most uncommon variant is the subserosal type characterized by primarily subserosal disease, eosinophilic ascites and peripheral hypereosinophilia. The clinical features are non-specific with history of atopic predisposition and allergy. Endoscopic biopsy is frequently non-diagnostic due to an uninvolved gastrointestinal mucosa rendering its diagnosis a challenge. The mainstay of diagnosis is peripheral hypereosinophilia and eosinophil-rich ascitic fluid on diagnostic paracentesis. Oral steroid therapy is usually the first line of treatment with dramatic response. Due to a propensity for relapse, steroid-sparing therapy should be considered for relapses of EGE. We report a case of subserosal EGE with diagnostic clinical features and treatment response and review the current strategy in the management of eosinophilic ascites.

关 键 词：Gastrointestinal ATOPY EOSINOPHILIC ASCITES Endoscopic biopsy EOSINOPHILIA 

分 类 号：R442.5[医药卫生—诊断学]