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Query: UMLS:C0024523 (malabsorption)
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Four cases of chronic eosinophilic gastroenteritis in horses are described. The disease was manifested clinically by weight loss, malabsorption and diarrhea of soft, formless feces. A chronic inflammatory reaction, with diffuse and focal eosinophilic infiltrates, was present in the esophagus, stomach, small and large intestine, and mesenteric lymph nodes. The cause of the lesion was not determined but was thought to the due to an ingested allergen, as the lesion is indicative of an on-going, immediate hypersensitivity reaction. One horse had generalized acanthosis, hyperkeratosis, and ulcerative coronitis.
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PMID:Chronic eosinophilic gastroenteritis in the horse. 714 8

Eosinophilic gastroenteropathy is an uncommon, idiopathic disease in children that is characterized by eosinophilic inflammation of the intestine. Predominant involvement of the mucosa is associated with diarrhea and less commonly gastrointestinal protein and fat malabsorption. A seven-year-old female was diagnosed with eosinophilic gastroenteritis. This condition was proven by biopsies attained through an endoscope. The most common symptoms were abdominal pain, diarrhea and edema. The patient had no eosinophilia. Her serum immunoglobulin E level was increased (1590 mg/dl). Barium studies revealed mucosal thickening of the antrum, distal jejunum and proximal ileum and prominent mucosal folds of the colon. Ultrasound examination revealed thickening of the colonic wall. The patient was treated with prednisolone (2 mg/kg/day). The symptoms subsided and serum immunoglobulin E decreased to 500 mg/dl 45 days later. The patient is being followed with a small maintenance dose of prednisolone with no relapse.
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PMID:Eosinophilic gastroenteritis presenting as protein--losing enteropathy (case report). 773 7

Idiopathic hypereosinophilic syndrome (IHES) is a multi-system disorder of unknown origin with eosinophilic infiltration of bone marrow and various organs, including the gastrointestinal tract. Involvement of the heart has a poor prognosis. The etiology of eosinophilic gastroenteritis (EGE) also is unclear. In this disease there is exclusive involvement of the gastrointestinal tract (including liver/bile ducts) and prognosis usually is good. Transition from one disease to the other has not yet been described. We report the 20 years' history of a male patient with an initial IHES without gastrointestinal symptoms and transition to a clinically pure EGE with resolution of any other involvement. At the age of 45 years the patient developed IHES with fever and constitutional symptoms. Fluctuating eosinophilia and symptoms necessitated continuous steroid therapy. After a 10 years' disease course watery diarrhea and malabsorption syndrome became more and more prominent. On the other hand, bone marrow eosinophilia regressed completely and blood eosinophilia partially. Biopsies showed a severe EGE of the mucosal type with involvement of the whole gastrointestinal tract. Besides the prominent eosinophilia there was a dense infiltration of the intestinal mucosa with T-lymphocytes invading the epithelium. We postulate that the destructive eosinophilic/lymphocytic inflammation is caused by a pathologic proliferation of T-lymphocytes with liberation of type 2 helper cell cytokines and consecutive stimulation of eosinophils.
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PMID:[Prolonged course of an idiopathic hypereosinophilic syndrome with transition to eosinophilic gastroenteritis]. 797 31

We describe the case of a 33 year-old woman who was hospitalized for ascites, abdominal pain and food allergy. Blood samples and histologic examination of a jejunal specimen removed by laparotomy revealed that the patient suffered from eosinophilic gastroenteritis. This disease is classified among the hypereosinophilic syndromes, and food allergy may be of etiologic importance. Clinically eosinophilic gastroenteritis may present with ascites, malabsorption or gut obstruction. The eosinophilic blood cell count is usually elevated and the erythrocyte sedimentation rate is usually normal or slightly increased. Polyarteritis nodosa, Crohn's disease and nematodal infections of the gut must be excluded. Most patients respond well to corticosteroid therapy and the long-term prognosis is good, even though the disease is chronic in nature.
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PMID:[Eosinophilic gastroenteritis]. 836 89

Two patients with eosinophilic gastroenteritis are described. The predominant eosinophilic infiltration of the mucosal layer of the upper gastrointestinal tract resulted in severe protein-losing enteropathy and peripheral eosinophilia in one patient and a malabsorption syndrome due to saccharose and lactose intolerance in another patient. There was a wide range of abdominal symptoms, depending on the site and extent of the disease. The diagnosis was based upon typical biopsy findings. There was a marked lack of any biochemical abnormality. The course of the disease was chronic and relapsing. Symptoms were not controlled with corticosteroids alone; only after the addition of disodium chromoglycate per os was prolonged disease control achieved.
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PMID:Eosinophilic gastroenteritis--a disease with a wide clinical spectrum. 837 80

We describe a patient with idiopathic hypereosinophilic syndrome, without initial gastrointestinal symptoms, and their transition to eosinophilic gastroenteritis. This patient, a 65-year-old man, presented with fever, constitutional symptoms, peripheral and bone marrow eosinophilia 20 years ago. During the course of the disease, diarrhoea and malabsorption became prominent, whereas bone marrow eosinophilia regressed completely and blood eosinophilia regressed partially. Biopsies showed a severe eosinophilic gastroenteritis of the mucosal type involving the stomach, small bowel and colon. During the final years of the patient's disease, mucosal eosinophilia became less intense and a mucosal infiltration with T-cells dominated. At autopsy, immunopathological studies of small intestines and colon specimens showed a clonal expansion of morphologically normal T-cells in the intestinal mucosa, which expressed the abnormal phenotype CD2+CD3+CD4-CD5-CD8-. Flow cytometry examination of peripheral blood revealed a corresponding abnormal population of CD3+CD4-CD8- T-cells, indicating a systemic spread of the process. The patient eventually died of non-obstructive small bowel infarction with peritonitis 20 years after the onset of the first symptoms. We postulate that the destructive eosinophilic/lymphocytic inflammation is caused by a clonal proliferation of T-lymphocytes with probable secretion of Type 2 T(helper) cell cytokines and consecutive stimulation of eosinophils.
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PMID:Long-term outcome of idiopathic hypereosinophilic syndrome--transition to eosinophilic gastroenteritis and clonal expansion of T-cells. 872 26

A 24-yr-old female presented with a giant gastric ulcer and anemia. She suffered from a transient infantile malabsorption syndrome with eosinophilia. The diagnosis of eosinophilic gastroenteritis associated with the gastric ulcer was made by endoscopic biopsy. Ulcer healing was refractory to medical therapy and partial gastrectomy was performed. Histologic examination revealed transmural eosinophilic infiltrates with mast cell infiltrates in the gastric wall. This case illustrates (1) an extremely rare presentation of eosinophilic gastroenteritis--giant, refractory, gastric ulcer; (2) a potential pathogenic role for mast cells in this syndrome; and (3) the chronic and relapsing nature of the syndrome.
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PMID:Giant antral ulcer: a rare presentation of eosinophilic gastroenteritis--case report and review of the literature. 921 1

Eosinophilic gastroenteritis is an uncommon chronic disease, of unknown cause, characterized by eosinophilic infiltration of the gastrointestinal tract, which is usually associated with peripheral blood eosinophilia. The symptoms of this complex disorder are variable, and frequently include abdominal pain, nausea, diarrhea, protein losing enteropathy and malabsorption. In general, patients can be successfully treated with corticosteroids, but relapses are common. We present the first case of a 6-year-old boy with Albright's hereditary osteodystrophy (Pseudohypoparathyroidism Ia) associated with eosinophilic gastroenteritis. Alternatives to traditional treatment with corticosteroids are discussed.
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PMID:[Eosinophilic gastroenteritis in a patient with Albright's hereditary osteodystrophy]. 1204 57

Eosinophilic gasteroenteritis is an uncommon disease with variable clinical features characterized by eosinophilic infiltration. Clinical manifestations range from non-specific gastrointestinal complaints such as nausea, vomiting, crampy abdominal pain, and diarrhea to specific findings such as malabsorption, protein loosing enteropathy, luminal obstruction, eosinophilic ascites and effusion. We report here on a case of eosinophilic gastroenteritis causing enterobiliary fistula which is an extremely unusual complication.
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PMID:Enterobiliary fistula as a complication of eosinophilic gastroenteritis: a case report. 1852 31

Previously described treatments used for eosinophilic diseases of the gastrointestinal tract have included dietary restrictions primarily of cow milk protein, anti-inflammatory therapy utilizing suplatast, budesonide and corticosteroids, cromolyn sodium, anti-histamines and oral inhalable steroids. We describe a 12-year-old girl with diarrhea and malabsorption, who was later diagnosed to have eosinophilic gastroenteritis, was unresponsive to standard therapies, but exhibited marked improvement with use of montelukast.
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PMID:Malabsorption syndrome and leukotriene inhibitor. 2057 Nov 53


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