Eosinophilic Colitis in Recurrent Sigmoid Volvulus

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ABSTRACT

Eosinophilic colitis (EC) falls along the spectrum of a series of inflammatory gastrointestinal disorders in which eosinophils infiltrate the gut without known tissue eosinophilia. Eosinophilic gastrointestinal disorders include eosinophilic esophagitis, eosinophilic gastritis, and the least common EC. The presentation of EC is extremely variable in mucosal, submucosal, and transmural inflammation. We present a case of recurrent volvulus with histologic findings of eosinophilia.

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Eosinophilic colitis: an update on pathophysiology and treatment.

Martin Storr, Thomas E. Shaffer, Assim Alfadda (2010)

Primary eosinophilic gastrointestinal disorders, a spectrum of inflammatory conditions, occurs when eosinophils selectively infiltrate the gut in the absence of known causes for such tissue eosinophilia. These may be classified into eosinophilic esophagitis, eosinophilic gastroenteritis and eosinophilic colitis (EC). This review focuses on EC: its pathogenesis, epidemiology, clinical presentation, diagnosis and current approach to treatment. A literature review published in English was performed using Pubmed, Ovid, Google scholar search engines with the following keywords: eosinophilic gastrointestinal disorder, EC, eosinophils, colitis and gastrointestinal. The basis for primary EC appears related to increased sensitivity to allergens, principally as a food allergy in infants and a T lymphocyte-mediated event in adults. Endoscopic changes are generally modest, featuring edema and patchy granularity. Clear clinical and pathological diagnostic criteria of EC and its management strategy. Intestinal involvement of EC is primarily mucosal, presenting as a mild self-limited proctitis in infants and self-limited colitis in young adults. Therapeutic approaches based on case reports tend to use either elimination diets to avoid a presumed allergen; agents traditionally used in inflammatory disease or targeted drugs like anti-histamines or leukotriene receptor antagonists. Prospective randomized controlled trials addressing the disease natural history, possible preventive methods and effective medical approach and long-term prognosis are required.

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Eosinophilic colitis: A clinical review.

Giovanna Impellizzeri, Giovanni Marasco, Leonardo Eusebi … (2019)

Eosinophilic colitis is a rare entity characterized by the presence of a high eosinophilic infiltrate into the colonic wall in symptomatic patients, more often presenting with abdominal pain or diarrhea. These characteristics distinguish eosinophilic colitis from primary colonic eosinophilia, in which patients are asymptomatic. Primary colonic eosinophilia does not need any therapy, while eosinophilic colitis requires a strict treatment, similar to that of the more codified chronic intestinal inflammatory diseases. To date the lack of codified guidelines regarding the diagnostic criteria and the eosinophil threshold values for each colonic segment are the main diagnostic challenge for eosinophilic colitis. In addition, eosinophilic colitis is a diagnosis of exclusion, once all other causes of colonic eosinophilia (food allergens, infections, drugs, etc.) have been excluded. Several treatment options are available for eosinophilic colitis, although the evidence for most of them is limited to case reports and small case series. We examine the epidemiology, etiology, pathophysiology, diagnostic criteria and therapeutic options of eosinophilic colitis reporting recent evidence from the current literature.

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Eosinophilic colitis.

György Baffy, Bassam Aswad, Nnenna Okpara (2009)

Eosinophilic colitis (EC) is a rare form of primary eosinophilic gastrointestinal disease with a bimodal peak of prevalence in neonates and young adults. EC remains a little understood condition in contrast to the increasingly recognized eosinophilic esophagitis. Clinical presentation of EC is highly variable according to mucosal, transmural, or serosal predominance of inflammation. EC has a broad differential diagnosis because colon tissue eosinophilia often occurs in parasitic infection, drug-induced allergic reactions, inflammatory bowel disease, and various connective tissue disorders, which require thorough searching for secondary causes that may be specifically treated with antibiotics or dietary and drug elimination. Like eosinophilic gastrointestinal disease involving other segments of the gastrointestinal tract, EC responds very well to steroids that may be spared by using antihistamines, leukotriene inhibitors and biologics.

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Author and article information

Contributors

Faruq Pradhan

Adam Gomez

Rakesh Nanda

Journal

Journal ID (nlm-ta): ACG Case Rep J

Journal ID (iso-abbrev): ACG Case Rep J

Journal ID (coden): ACGCRJ

Journal ID (pmc): ACGCRJ

Journal ID (publisher-id): AC9

Title: ACG Case Reports Journal

Publisher: Wolters Kluwer (Maryland, MD )

ISSN (Electronic): 2326-3253

Publication date Collection: August 2021

Publication date (Electronic): 25 August 2021

Volume: 8

Issue: 8

Electronic Location Identifier: e00650

Affiliations

[1 ]Department of Gastroenterology, Carl T. Hayden VA Medical Center, Phoenix, Arizona

[2 ]Department of Pathology, Carl T. Hayden VA Medical Center, Phoenix, Arizona

Author notes

Correspondence: Kelly Zucker, DO ( Kelly.zucker@ 123456bannerhealth.com ).

Article

Publisher ID: ACGCR-20-1304 Accession ID: 00007

DOI: 10.14309/crj.0000000000000650

PMC ID: 8389955

SO-VID: 11d30ff8-9e4c-44c7-81d6-12375acd764c

Copyright © Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.

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This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

History

Date received : 12 November 2020

Date accepted : 30 March 2021

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Eosinophilic Colitis in Recurrent Sigmoid Volvulus

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ABSTRACT

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European Journal of Medical Case Reports (EJMCR)

Most cited references 4

Eosinophilic colitis: an update on pathophysiology and treatment.

Eosinophilic colitis: A clinical review.

Eosinophilic colitis.

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