EOSINOPHILIC GASTROINTESTINAL DISORDERS: EXPERIENCE OF A TUNISIAN CENTER

*Elleuch Nour, Sonda Jardak, Dahmani Wafa, Jaziri Hanene, Aida Ben Slama, Aya Hammami, Salem Ajmi, Braham Ahlem, Ksiaa Mehdi and Jmaa Ali

ABSTRACT

Introduction: Eosinophilic gastrointestinal disorders (EGD) are rare chronic digestive pathologies characterized by an eosinophilic infiltration of the digestive tract in the absence of secondary causes for eosinophilia. Their diagnosis reprensents a real challenge to clinicians because of aspecific clinical features. Objective: to analyze the clinical, biological, radiological characteristics of EGD as well as the endoscopic, histological and therapeutic features of these disorders through to the experience of a Tunisian center. Methods: a retrospective study from 2006 to 2017 including patients diagnosed with EGD based on three criteria: Suspicious clinical symptoms, histologic evidence of eosinophilic infiltration in the bowel and exclusion of other pathologies with similar findings. Results: A total of 16 cases of EGD were collected, divided into eosinophilic esophagitis (9 patients), eosinophilic gastroenteritis (3 patients) and eosinophilic colitis (4 patients). Mean age was 36.8 (12-52 years). The sex ratio was 1.66 (M/F=10/6). More than half of patients had a personal history of atopic disease (n=9). Symptoms were non-specific and various: dysphagia (n=7), diarrhea (n=3), abdomianl pain (n=3), vomiting (n=2) and ascitis (n=1). The third of patients had increased numbers of circulating eosinophils. Total IgE levels were increased in 37.5% of patients (n=6). The definitive diagnosis was based on histological results : tissue obtained during upper gastro intestinal endoscopy (n=11), colonoscopy (n=4) and laparoscopy (n=1). The treatment was based on corticosteroids (n=9), proton pump inhibitor (n=4), salicylates (n=2) and dietary therapy (n=1). Conclusion: EGD are uncommon and heterogeneous diseases. Up to now, many problems still left to be answered. In the future, large and high-quality studies are needed to further investigate the pathophysiology of EGD and to make standard guidelines for the diagnosis and management.

Keywords: Eosinophilic esophagitis, Eosinophilic gastroenteritis, Diagnosis, Therapy.