Abstract
“Uncommon Culprit: A Rare Case of Chronic Diarrhea Caused by Eosinophilic Enterocolitis”
Patrick Michael L. Roslyn, MD
Section of Gastroenterology, Department of Internal Medicine, East Avenue Medical Center
Significance: Eosinophilic enterocolitis is a remarkably rare form of Eosinophilic Gastrointestinal Disease (EGID) with its exact worldwide prevalence unknown. There is limited data available with regards to standardized criteria for diagnosis and validated guidelines for the treatment of the disease. This paper will discuss the diagnosis and management of a case of eosinophilic enterocolitis, serosal type.
Clinical Presentation: A case of 61-year-old female presenting with chronic diarrhea, abdominal pain, weight loss and ascites.
Management: Patient was initially managed as a case of infectious diarrhea with empiric IV antibiotics. Blood works revealed presence of peripheral eosinophilia with an absolute eosinophil count of 4690. Fecalysis and stool culture was unremarkable. Colonoscopy revealed Ileo-colitis with biopsy results showing extensive eosinophilic infiltration (>100/hpf) in the lamina propria and submucosa of the terminal ileum up to the rectum. Histopathology was negative for malignancy. TB PCR was negative. CT scan of the abdomen showed thickening of the walls of the small bowel loops to transverse colon with presence of ascites. Patient was managed as a case of eosinophilic enterocolitis. Prednisone (1mg/kg/d) was started and tapered off within 4 weeks with subsequent improvement of clinical symptoms and resolution of ascites.
Recommendation: Eosinophilic enterocolitis remains a diagnosis of exclusion and requires a high index of clinical suspicion. Further research is warranted to better understand disease etiology, diagnosis and treatment of the disease.
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |