Abstract:

Objectives To investigate the clinical features and prognosis of eosinophilic gastroenteritis (EGE). Methods Seventy-one cases diagnosed with EGE in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from October in 2003 to May in 2019 were recruited. The prognosis was followed up by telephone. The information including clinical manifestations, laboratory tests results, radiological features, endoscopic and pathological results, as well as prognosis were collected, and the statistical analysis was carried out using SPSS software. Results Seventy-one EGE patients [mean age （25.18±21.44）years, 64.8% males] were recruited in our study. 28/71(39.4%) cases had allergic history, in which 48.1% ones had food allergy. Abdominal pain (74.6%) was the most common symptom in the patients. The proportion of elevated peripheral blood eosinophils (EOS) direct count was significantly higher than that of EOS indirect count (P=0.043). 43/51 cases received gastroscopy biopsy and 45/53 cases received colonoscopy biopsy. As tissue EOS infiltration ≥20/HPF（high power field）was defined as pathologically positive, the positive rate of biopsy was significantly correlated with the number of biopsied sites (gastric: P=0.012, intestinal: P=0.014), but was not related to the total number of biopsy tissues(gastric: P=0.381, intestinal: P=0.553). 57/71 cases were followed-up successfully by telephone, in which 63.2% ones had recurrence. The patients with a higher rate of elevated peripheral EOS direct count and serum CRP (C-reactive protein), as well as a higher level of intestinal tissue EOS infiltration, showed significantly higher recurrence rate (P<0.05). The EGE patients using microflora regulator agents had significantly reduced recurrence rate [odds ratio (OR)=0.254, 95% confidence interval (CI): 0.068-0.946, P=0.041]. Conclusions EGE, as the disease commonly seen in young and middle-aged patients, is a chronic digestive disease related to food allergy, and its’ common clinical manifestation is abdominal pain. Testing peripheral EOS direct count could be more beneficial for the accurate assessment of peripheral EOS level. Multi-sites gastrointestinal endoscopy biopsy is helpful to increase the pathologically positive rate of EGE diagnosis. Increase of peripheral EOS count, serum CRP and intestinal EOS infiltration can be used to predict a higher risk of recurrence. Microflora regulator agents might help reduce the recurrence rate of EGE.

Key words: Eosinophilic gastroenteritis, Clinical manifestation, Radiology, Pathology, Prognosis