Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
권호 표지
DOI QR코드

DOI QR Code

A Rare Case of Eosinophilic Gastroenteritis in a Neonate with Fever

  • Lee, Minkyeong (Department of Pediatrics, Inje University Haeundae Paik Hospital) ;
  • Choi, So Yoon (Department of Pediatrics, Inje University Haeundae Paik Hospital) ;
  • Chung, Mi Lim (Department of Pediatrics, Inje University Haeundae Paik Hospital) ;
  • Lee, Jonghyun (Department of Pediatrics, Soonchunhyang University Gumi Hospital) ;
  • Sung, Myongsoon (Department of Pediatrics, Soonchunhyang University Gumi Hospital)
  • Received : 2019.04.26
  • Accepted : 2019.07.10
  • Published : 2019.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Eosinophilic gastroenteritis is a member of eosinophilic gastrointestinal (GI) diseases and is characterized by the accumulation of eosinophils within the GI tract. Common symptoms of eosinophilic gastroenteritis are vomiting, abdominal pain, dysphagia, and weight loss, but rare fever in neonate. This report describes a 10-day-old boy who developed fever, bloody mucoid stool, and bilious vomiting resulting from eosinophilic gastroenteritis, mimicking sepsis. Sigmoidoscopy and pathologic findings revealed mucosal edema, small hemorrhagic spot, and segmental erythemoid edema in the colon and increased number of eosinophils in the lamina propria with intraepithelial eosinophils. After breast milk feeding with restriction of milk from the mother for 6 months, specific immunoglobulin to milk was class 0 (class 3, previous). The boy restarted formula feeding, and he had no fever and GI symptoms.

Keywords

References

  1. Spergel JM, Book WM, Mays E, Song L, Shah SS, Talley NJ, et al. Variation in prevalence, diagnostic criteria, and initial management options for eosinophilic gastrointestinal diseases in the United States. J Pediatr Gastroenterol Nutr 2011;52:300-6. https://doi.org/10.1097/MPG.0b013e3181eb5a9f
  2. Guajardo JR, Plotnick LM, Fende JM, Collins MH, Putnam PE, Rothenberg ME. Eosinophil-associated gastrointestinal disorders: a world-wide-web based registry. J Pediatr 2002;141:576-81. https://doi.org/10.1067/mpd.2002.127663
  3. Whitaker IS, Gulati A, McDaid JO, Bugajska-Carr U, Arends MJ. Eosinophilic gastroenteritis presenting as obstructive jaundice. Eur J Gastroenterol Hepatol 2004;16:407-9. https://doi.org/10.1097/00042737-200404000-00007
  4. Treiber GG, Weidner S. Eosinophilic gastroenteritis. Clin Gastroenterol Hepatol 2007;5:e16. https://doi.org/10.1016/j.cgh.2007.01.011
  5. Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004;113:11-28; quiz 29. https://doi.org/10.1016/j.jaci.2003.10.047
  6. Chehade M, Aceves SS. Food allergy and eosinophilic esophagitis. Curr Opin Allergy Clin Immunol 2010;10:231-7. https://doi.org/10.1097/ACI.0b013e328338cbab
  7. Lucendo AJ, Arias A. Eosinophilic gastroenteritis: an update. Expert Rev Gastroenterol Hepatol 2012;6:591-601. https://doi.org/10.1586/egh.12.42
  8. Abassa KK, Lin XY, Xuan JY, Zhou HX, Guo YW. Diagnosis of eosinophilic gastroenteritis is easily missed. World J Gastroenterol 2017;23:3556-64. https://doi.org/10.3748/wjg.v23.i19.3556
  9. Sopo SM, Filoni S, Giorgio V, Monaco S, Onesimo R. Food protein-induced enterocolitis syndrome (FPIES) to corn: a case report. J Investig Allergol Clin Immunol 2012;22:391-2.
  10. Nomura I, Morita H, Hosokawa S, Hoshina H, Fukuie T, Watanabe M, et al. Four distinct subtypes of non-IgE-mediated gastrointestinal food allergies in neonates and infants, distinguished by their initial symptoms. J Allergy Clin Immunol 2011;127:685-8. https://doi.org/10.1016/j.jaci.2011.01.019
  11. Fogg MI, Brown-Whitehorn TA, Pawlowski NA, Spergel JM. Atopy patch test for the diagnosis of food protein-induced enterocolitis syndrome. Pediatr Allergy Immunol 2006;17:351-5. https://doi.org/10.1111/j.1399-3038.2006.00418.x
  12. Eigenmann PA, Belli DC, Ludi F, Kahn JM, Polla BS. In vitro lymphocyte proliferation with milk and a casein-whey protein hydrolyzed formula in children with cow's milk allergy. J Allergy Clin Immunol 1995;96:549-57. https://doi.org/10.1016/S0091-6749(95)70300-4
  13. Bolukbas FF, Bolukbas C, Uzunkoy A, Baba F, Horoz M, Ozturk E. A dramatic response to ketotifen in a case of eosinophilic gastroenteritis mimicking abdominal emergency. Dig Dis Sci 2004;49:1782-5. https://doi.org/10.1007/s10620-004-9570-7
  14. Bischoff SC. Food allergy and eosinophilic gastroenteritis and colitis. Curr Opin Allergy Clin Immunol 2010;10:238-45. https://doi.org/10.1097/ACI.0b013e32833982c3
  15. Chehade M, Magid MS, Mofidi S, Nowak-Wegrzyn A, Sampson HA, Sicherer SH. Allergic eosinophilic gastroenteritis with protein-losing enteropathy: intestinal pathology, clinical course, and long-term follow-up. J Pediatr Gastroenterol Nutr 2006;42:516-21. https://doi.org/10.1097/01.mpg.0000221903.61157.4e
  16. Tan AC, Kruimel JW, Naber TH. Eosinophilic gastroenteritis treated with non-enteric-coated budesonide tablets. Eur J Gastroenterol Hepatol 2001;13:425-7. https://doi.org/10.1097/00042737-200104000-00021
  17. Siewert E, Lammert F, Koppitz P, Schmidt T, Matern S. Eosinophilic gastroenteritis with severe protein-losing enteropathy: successful treatment with budesonide. Dig Liver Dis 2006;38:55-9. https://doi.org/10.1016/j.dld.2005.06.013
  18. Choi BS, Hong SJ, Park SH, Kim HM, Choe BH. Differences in features and course of mucosal type eosinophilic gastroenteritis between Korean infants and children. J Korean Med Sci 2015;30:1129-35. https://doi.org/10.3346/jkms.2015.30.8.1129