A Case of Steroid Dependent Eosinophilic Gastroenteritis Presenting as a Huge Gastric Ulcer |
Yeon Ji Kim, Woo Chul Chung, Yaeni Kim, Yoon Yung Chung, Kang Moon Lee, Chang Nyo Paik, Hyung Min Chin, Hyun Joo Choi |
1Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea. jwchulkr@yahoo.co.kr 2Department of Surgery, The Catholic University of Korea, College of Medicine, Seoul, Korea. 3Department of Pathology, The Catholic University of Korea, College of Medicine, Seoul, Korea. |
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Abstract |
Eosinophilic gastroenteritis is defined as primary eosinophilic infiltration of the gastrointestinal tract. Endoscopic findings of this disease entity are non-specific, and huge gastric ulceration as initial presentation is extremely rare. We experienced a case of eosinophilic gastroenteritis presenting with abdominal pain in a 38 year-old-woman. Deep and huge ulceration in gastric antrum and body looked like advanced gastric cancer. Surgical resection was performed and histopathological examination showed dense infiltration of eosinophil without malignant cells. 5 years after surgery, diffuse abdominal pain and generalized edema developed and computed tomography showed entire wall thickening of the gastrointestinal tract. Random mucosal biopsy of the remnant stomach and terminal ileum showed mucosal eosinophilic infiltrations. She was treated with steroids and azathioprine but experienced frequent relapses and was dependent on steroids to maintain remissions. After 3 years, she died from infective endocarditis due to the prolonged use of immunosuppressive agents. |
Key Words:
Eosinophilic gastroenteritis; Gastric ulcer; Immunosuppressive agents |
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