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Eosinophilic gastroenteritis due to egg allergy presenting as acute pancreatitis.

Tse KY, Christiansen SC - Allergy Rhinol (Providence) (2015)

Bottom Line: We describe a case of a 25-year-old female with newly diagnosed egg allergy, presenting with both peripheral and duodenal eosinophilia suspicious for eosinophilic gastroenteritis (EG).Cessation of all egg products lead to resolution of all symptoms.This represents the first report of EG manifesting as pancreatitis due to egg ingestion.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of California at San Diego, La Jolla, California, USA.

ABSTRACT
We describe a case of a 25-year-old female with newly diagnosed egg allergy, presenting with both peripheral and duodenal eosinophilia suspicious for eosinophilic gastroenteritis (EG). The EG was severe enough to have likely caused acute pancreatitis. Cessation of all egg products lead to resolution of all symptoms. This represents the first report of EG manifesting as pancreatitis due to egg ingestion.

No MeSH data available.


Related in: MedlinePlus

Photomicrograph of duodenal wall biopsy showing infiltration of eosinophils. Low- and high (inset)-power magnification of duodenal biopsy specimen obtained during acute episode of pancreatitis. Region shown by high-power magnification is boxed, and reveals numerous eosinophils (80 high powered field), consistent with the diagnosis of EG. No villous blunting was seen.
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Figure 1: Photomicrograph of duodenal wall biopsy showing infiltration of eosinophils. Low- and high (inset)-power magnification of duodenal biopsy specimen obtained during acute episode of pancreatitis. Region shown by high-power magnification is boxed, and reveals numerous eosinophils (80 high powered field), consistent with the diagnosis of EG. No villous blunting was seen.

Mentions: The eosinophilia persisted throughout her admission and for the subsequent week, peaking at 26% (2500 eos/μL). A right upper quadrant ultrasound, abdominal CT, and MRCP did not show evidence of biliary dilatation or obstruction that would have suggested the presence of gallstones. Other causes of pancreatitis, including alcohol and medications, were ruled out. Endoscopic evaluation showed normal appearing mucosa, and esophageal biopsies were normal. However, a biopsy of the duodenum revealed 80 eos/high powered field (Fig. 1). A stool sample for ova and parasite was negative except for the presence of Charcot Leyden crystals, suggesting an underlying GI eosinophilic process. Suspecting that the patient's symptoms were being triggered by egg ingestion, in vitro allergy testing was performed and demonstrated a positive egg-specific IgE level at 6.25 kU/L (all other tested foods were negative, total IgE 89.7 kU/L).


Eosinophilic gastroenteritis due to egg allergy presenting as acute pancreatitis.

Tse KY, Christiansen SC - Allergy Rhinol (Providence) (2015)

Photomicrograph of duodenal wall biopsy showing infiltration of eosinophils. Low- and high (inset)-power magnification of duodenal biopsy specimen obtained during acute episode of pancreatitis. Region shown by high-power magnification is boxed, and reveals numerous eosinophils (80 high powered field), consistent with the diagnosis of EG. No villous blunting was seen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388883&req=5

Figure 1: Photomicrograph of duodenal wall biopsy showing infiltration of eosinophils. Low- and high (inset)-power magnification of duodenal biopsy specimen obtained during acute episode of pancreatitis. Region shown by high-power magnification is boxed, and reveals numerous eosinophils (80 high powered field), consistent with the diagnosis of EG. No villous blunting was seen.
Mentions: The eosinophilia persisted throughout her admission and for the subsequent week, peaking at 26% (2500 eos/μL). A right upper quadrant ultrasound, abdominal CT, and MRCP did not show evidence of biliary dilatation or obstruction that would have suggested the presence of gallstones. Other causes of pancreatitis, including alcohol and medications, were ruled out. Endoscopic evaluation showed normal appearing mucosa, and esophageal biopsies were normal. However, a biopsy of the duodenum revealed 80 eos/high powered field (Fig. 1). A stool sample for ova and parasite was negative except for the presence of Charcot Leyden crystals, suggesting an underlying GI eosinophilic process. Suspecting that the patient's symptoms were being triggered by egg ingestion, in vitro allergy testing was performed and demonstrated a positive egg-specific IgE level at 6.25 kU/L (all other tested foods were negative, total IgE 89.7 kU/L).

Bottom Line: We describe a case of a 25-year-old female with newly diagnosed egg allergy, presenting with both peripheral and duodenal eosinophilia suspicious for eosinophilic gastroenteritis (EG).Cessation of all egg products lead to resolution of all symptoms.This represents the first report of EG manifesting as pancreatitis due to egg ingestion.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of California at San Diego, La Jolla, California, USA.

ABSTRACT
We describe a case of a 25-year-old female with newly diagnosed egg allergy, presenting with both peripheral and duodenal eosinophilia suspicious for eosinophilic gastroenteritis (EG). The EG was severe enough to have likely caused acute pancreatitis. Cessation of all egg products lead to resolution of all symptoms. This represents the first report of EG manifesting as pancreatitis due to egg ingestion.

No MeSH data available.


Related in: MedlinePlus