Eosinophilic gastroenteritis with severe protein-losing enteropathy: Successful treatment with budesonide

We report the clinical, laboratory, endoscopic and histopathological findings in a 40-year-old woman with watery diarrhoea and hypoproteinaemia. Elevated α 1-antitrypsin clearance confirmed massive protein-losing enteropathy. Gastroscopic and colonoscopic biopsies showed abundant infiltration of the...

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Bibliographic Details
Published in:Digestive and liver disease 2006, Vol.38 (1), p.55-59
Main Authors: Siewert, E., Lammert, F., Koppitz, P., Schmidt, T., Matern, S.
Format: Article
Language:English
Subjects:
Adult
Anti-Inflammatory Agents - therapeutic use
Biopsy
Budesonide
Budesonide - therapeutic use
Duodenum - pathology
Eosinophilia - complications
Eosinophilia - pathology
Eosinophilic gastroenteritis
Female
Gastroenteritis - complications
Gastroenteritis - pathology
Glucocorticoids
Humans
Ileum - pathology
Protein-Losing Enteropathies - drug therapy
Protein-Losing Enteropathies - etiology
Protein-losing enteropathy
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Description
Summary:We report the clinical, laboratory, endoscopic and histopathological findings in a 40-year-old woman with watery diarrhoea and hypoproteinaemia. Elevated α 1-antitrypsin clearance confirmed massive protein-losing enteropathy. Gastroscopic and colonoscopic biopsies showed abundant infiltration of the small bowel wall with eosinophils in proximal duodenum and terminal ileum, respectively. These findings established the diagnosis of eosinophilic gastroenteritis. Both the inflammatory alterations and the severe intestinal protein loss were successfully treated with budesonide, a topically active corticosteroid preparation with controlled small bowel release. The case report illustrates that remission of protein-losing enteropathy secondary to eosinophilic gastroenteritis can be achieved with budesonide, thus supporting its use for this uncommon disease characterised by inflammatory intestinal lesions.
ISSN:1590-8658
1878-3562
DOI:10.1016/j.dld.2005.06.013