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

• 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
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2005.06.013

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.