Clinical Features and Treatment Responses of Children With Eosinophilic Gastroenteritis

Clinical features and treatment responses in pediatric patients with eosinophilic gastroenteritis are rarely reported. This study aimed to evaluate the clinical manifestations and outcome of eosinophilic gastroenteritis in children of Asian background. Methods: Between 1997 and 2009, 14 Taiwanese pa...

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Main Authors: Fu-Mien Tien, Jia-Feng Wu, Yung-Ming Jeng, Hong-Yuan Hsu, Yen-Hsuan Ni, Mei-Hwei Chang, Dong-Tsamn Lin, Huey-Ling Chen
Format: Article
Language:English
Published: Elsevier 2011-10-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957211000969
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author Fu-Mien Tien
Jia-Feng Wu
Yung-Ming Jeng
Hong-Yuan Hsu
Yen-Hsuan Ni
Mei-Hwei Chang
Dong-Tsamn Lin
Huey-Ling Chen
author_facet Fu-Mien Tien
Jia-Feng Wu
Yung-Ming Jeng
Hong-Yuan Hsu
Yen-Hsuan Ni
Mei-Hwei Chang
Dong-Tsamn Lin
Huey-Ling Chen
author_sort Fu-Mien Tien
collection DOAJ
description Clinical features and treatment responses in pediatric patients with eosinophilic gastroenteritis are rarely reported. This study aimed to evaluate the clinical manifestations and outcome of eosinophilic gastroenteritis in children of Asian background. Methods: Between 1997 and 2009, 14 Taiwanese patients (nine boys and five girls), with median age of 8.3 years (range, 1.4–14.3 years), were diagnosed with eosinophilic gastroenteritis. The diagnosis was confirmed by the presence of gastrointestinal symptoms, peripheral eosinophilia, and a histology-proved biopsy. The clinical data and responses to medical treatment were analyzed. Results: Initial symptoms included abdominal pain (43%), anemia (36%), hypoalbuminemia (14%), recurrent vomiting (7%), bloody stool (7%), and growth failure (7%). Peripheral eosinophilia was present in 10 patients (71.4%) and positive stool occult blood in seven patients (50%). Endoscopic examination revealed ulcer disease in four patients (28.6%). The treatment included steroid alone, montelukast alone, steroid+montelukast, and steroid+montelukast+ketotifen. Among the patients treated with steroid, two (two of nine, 22%) had successfully tapered off steroid without recurring symptoms. Three patients (three of nine, 33%) had relapses after discontinuing steroid, three (three of nine, 33%) still required low-dose steroid, and one lost to follow-up. There was no relapse in the four patients treated with montelukast alone. Conclusions: A high percentage of patients presented with gross or occult gastrointestinal bleeding with or without abdominal pain. Endoscopic biopsy is necessary for diagnosis. Steroid was the mainstay treatment for active diseases; montelukast was also effective for the disease or as a maintenance therapy in this study.
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spelling doaj-art-d13e68cf408b4dcdab62da5ba1366a182025-08-20T02:19:55ZengElsevierPediatrics and Neonatology1875-95722011-10-0152527227810.1016/j.pedneo.2011.06.006Clinical Features and Treatment Responses of Children With Eosinophilic GastroenteritisFu-Mien Tien0Jia-Feng Wu1Yung-Ming Jeng2Hong-Yuan Hsu3Yen-Hsuan Ni4Mei-Hwei Chang5Dong-Tsamn Lin6Huey-Ling Chen7Department of Pediatrics, National Taiwan University Children’s Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Children’s Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Children’s Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Children’s Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Children’s Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Children’s Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Children’s Hospital and National Taiwan University College of Medicine, Taipei, TaiwanClinical features and treatment responses in pediatric patients with eosinophilic gastroenteritis are rarely reported. This study aimed to evaluate the clinical manifestations and outcome of eosinophilic gastroenteritis in children of Asian background. Methods: Between 1997 and 2009, 14 Taiwanese patients (nine boys and five girls), with median age of 8.3 years (range, 1.4–14.3 years), were diagnosed with eosinophilic gastroenteritis. The diagnosis was confirmed by the presence of gastrointestinal symptoms, peripheral eosinophilia, and a histology-proved biopsy. The clinical data and responses to medical treatment were analyzed. Results: Initial symptoms included abdominal pain (43%), anemia (36%), hypoalbuminemia (14%), recurrent vomiting (7%), bloody stool (7%), and growth failure (7%). Peripheral eosinophilia was present in 10 patients (71.4%) and positive stool occult blood in seven patients (50%). Endoscopic examination revealed ulcer disease in four patients (28.6%). The treatment included steroid alone, montelukast alone, steroid+montelukast, and steroid+montelukast+ketotifen. Among the patients treated with steroid, two (two of nine, 22%) had successfully tapered off steroid without recurring symptoms. Three patients (three of nine, 33%) had relapses after discontinuing steroid, three (three of nine, 33%) still required low-dose steroid, and one lost to follow-up. There was no relapse in the four patients treated with montelukast alone. Conclusions: A high percentage of patients presented with gross or occult gastrointestinal bleeding with or without abdominal pain. Endoscopic biopsy is necessary for diagnosis. Steroid was the mainstay treatment for active diseases; montelukast was also effective for the disease or as a maintenance therapy in this study.http://www.sciencedirect.com/science/article/pii/S1875957211000969childreneosinophiliaeosinophilic gastroenteritisgastrointestinal bleeding
spellingShingle Fu-Mien Tien
Jia-Feng Wu
Yung-Ming Jeng
Hong-Yuan Hsu
Yen-Hsuan Ni
Mei-Hwei Chang
Dong-Tsamn Lin
Huey-Ling Chen
Clinical Features and Treatment Responses of Children With Eosinophilic Gastroenteritis
Pediatrics and Neonatology
children
eosinophilia
eosinophilic gastroenteritis
gastrointestinal bleeding
title Clinical Features and Treatment Responses of Children With Eosinophilic Gastroenteritis
title_full Clinical Features and Treatment Responses of Children With Eosinophilic Gastroenteritis
title_fullStr Clinical Features and Treatment Responses of Children With Eosinophilic Gastroenteritis
title_full_unstemmed Clinical Features and Treatment Responses of Children With Eosinophilic Gastroenteritis
title_short Clinical Features and Treatment Responses of Children With Eosinophilic Gastroenteritis
title_sort clinical features and treatment responses of children with eosinophilic gastroenteritis
topic children
eosinophilia
eosinophilic gastroenteritis
gastrointestinal bleeding
url http://www.sciencedirect.com/science/article/pii/S1875957211000969
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