Eosinophilia in a patient with cyclical vomiting

A case report

Billy H. Copeland, Omolola O. Aramide, Salim A. Wehbe, S. Matthew Fitzgerald, Guha Krishnaswamy

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Eosinophilic gastritis is related to eosinophilic gastroenteritis, varying only in regards to the extent of disease and small bowel involvement. Common symptoms reported are similar to our patient's including: abdominal pain, epigastric pain, anorexia, bloating, weight loss, diarrhea, ankle edema, dysphagia, melaena and postprandial nausea and vomiting. Microscopic features of eosinophilic infiltration usually occur in the lamina propria or submucosa with perivascular aggregates. The disease is likely mediated by eosinophils activated by various cytokines and chemokines. Therapy centers around the use of immunosuppressive agents and dietary therapy if food allergy is a factor. Case presentation: The patient is a 31 year old Caucasian female with a past medical history significant for ulcerative colitis. She presented with recurrent bouts of vomiting, abdominal pain and chest discomfort of 11 months duration. The bouts of vomiting had been reoccurring every 7-10 days, with each episode lasting for 1-3 days. This was associated with extreme weakness and cachexia. Gastric biopsies revealed intense eosinophilic infiltration. The patient responded to glucocorticoids and azathioprine. The differential diagnosis and molecular pathogenesis of eosinophilic gastritis as well as the molecular effects of glucocorticoids in eosinophilic disorders are discussed. Conclusions: The patient responded to a combination of glucocorticosteroids and azathioprine with decreased eosinophilia and symptoms. It is likely that eosinophil-active cytokines such as interleukin-3 (IL-3), granulocyte macrophage colony stimulating factor (GM-CSF) and IL-5 play pivotal roles in this disease. Chemokines such as eotaxin may be involved in eosinophil recruitment. These mediators are downregulated or inhibited by the use of immunosuppressive medications.

Original languageEnglish (US)
Article number7
JournalClinical and Molecular Allergy
Volume2
DOIs
StatePublished - May 14 2004
Externally publishedYes

Fingerprint

Eosinophilia
Eosinophils
Vomiting
Azathioprine
Immunosuppressive Agents
Chemokines
Abdominal Pain
Glucocorticoids
Cytokines
Melena
Cachexia
Food Hypersensitivity
Interleukin-3
Interleukin-5
Anorexia
Granulocyte-Macrophage Colony-Stimulating Factor
Deglutition Disorders
Ulcerative Colitis
Ankle
Nausea

ASJC Scopus subject areas

  • Immunology and Allergy
  • Molecular Biology

Cite this

Copeland, B. H., Aramide, O. O., Wehbe, S. A., Fitzgerald, S. M., & Krishnaswamy, G. (2004). Eosinophilia in a patient with cyclical vomiting: A case report. Clinical and Molecular Allergy, 2, [7]. https://doi.org/10.1186/1476-7961-2-7

Eosinophilia in a patient with cyclical vomiting : A case report. / Copeland, Billy H.; Aramide, Omolola O.; Wehbe, Salim A.; Fitzgerald, S. Matthew; Krishnaswamy, Guha.

In: Clinical and Molecular Allergy, Vol. 2, 7, 14.05.2004.

Research output: Contribution to journalArticle

Copeland, BH, Aramide, OO, Wehbe, SA, Fitzgerald, SM & Krishnaswamy, G 2004, 'Eosinophilia in a patient with cyclical vomiting: A case report', Clinical and Molecular Allergy, vol. 2, 7. https://doi.org/10.1186/1476-7961-2-7
Copeland BH, Aramide OO, Wehbe SA, Fitzgerald SM, Krishnaswamy G. Eosinophilia in a patient with cyclical vomiting: A case report. Clinical and Molecular Allergy. 2004 May 14;2. 7. https://doi.org/10.1186/1476-7961-2-7
Copeland, Billy H. ; Aramide, Omolola O. ; Wehbe, Salim A. ; Fitzgerald, S. Matthew ; Krishnaswamy, Guha. / Eosinophilia in a patient with cyclical vomiting : A case report. In: Clinical and Molecular Allergy. 2004 ; Vol. 2.
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