Acute eosinophilic pneumonia(AEP) is a pulmonary condition characterized by acute febrile illness and respiratory distress,with bilateral pulmonary infiltrates,particularly eosinophilic infiltration of the lungs.^([1]...Acute eosinophilic pneumonia(AEP) is a pulmonary condition characterized by acute febrile illness and respiratory distress,with bilateral pulmonary infiltrates,particularly eosinophilic infiltration of the lungs.^([1])Amiodarone,a widely applied antiarrhythmic agent,has been reported as a potential cause of drug-induced AEP.^([2]) Most reported cases of amiodarone-induced AEP typically occur following prolonged exposure for two months or more.展开更多
BACKGROUND Hepatic eosinophilic pseudotumor(HEPT)is a rare condition that mimics ma-lignant hepatic tumors,posing significant diagnostic challenges.This case report highlights the importance of considering parasitic i...BACKGROUND Hepatic eosinophilic pseudotumor(HEPT)is a rare condition that mimics ma-lignant hepatic tumors,posing significant diagnostic challenges.This case report highlights the importance of considering parasitic infections like Fasciola hepatica(F.hepatica)in the differential diagnosis of hepatic masses,especially in endemic regions,to prevent unnecessary interventions.CASE SUMMARY A 40-year-old female presented with a 1-month history of epigastric pain and significant weight loss.Imaging revealed a hepatic mass,initially misdiagnosed as intrahepatic cholangiocarcinoma.Laboratory results showed marked eosinophilia,and histopathological examination confirmed significant eosinophilic infiltration without malignancy.Serological testing identified F.hepatica infection.The patient was treated with a single dose of triclabendazole,leading to complete symptom resolution and normalization of hepatic imaging findings within days.CONCLUSION HEPT due to F.hepatica can closely mimic malignancy;timely antiparasitic treat-ment is crucial for resolution.展开更多
1.Introduction Eosinophils are granulocytes derived from bone marrow and are typically present in low numbers in the peripheral blood of healthy individuals[1].They originate from CD34+hematopoietic stem cells in the ...1.Introduction Eosinophils are granulocytes derived from bone marrow and are typically present in low numbers in the peripheral blood of healthy individuals[1].They originate from CD34+hematopoietic stem cells in the bone marrow.In type 2 inflammatory conditions,bone marrow eosinopoiesis increases,leading to a higher release of mature eosinophils into the bloodstream[1].Once in circulation,eosinophils can migrate to various tissues and organs under both physiologic and pathological conditions.During eosinophilopoiesis.展开更多
BACKGROUND Eosinophilic gastrointestinal(GI)disease(EGID)beyond eosinophilic esophagitis is not commonly reported in the developing world.AIM To estimate the prevalence of EGID in a selected group of pediatric patient...BACKGROUND Eosinophilic gastrointestinal(GI)disease(EGID)beyond eosinophilic esophagitis is not commonly reported in the developing world.AIM To estimate the prevalence of EGID in a selected group of pediatric patients suffering from non-functional chronic abdominal pain(CAP).METHODS A retrospective analysis was conducted on case records of children with CAP.Those exhibiting clinical or laboratory alarming features underwent endoscopic evaluation.Histopathology reports from upper GI endoscopy and ileo-colonoscopy determined the diagnosis of EGID.Subsequent analyses included clinical presentations,presence of atopy in the children or family,hemoglobin,albumin,serum immunoglobulin E(IgE),fecal calprotectin levels,endoscopic appearances,treatment methods,and outcomes.RESULTS A total of 368 children with organic CAP were subjected to endoscopic evaluation.Among them,19(5.2%)patients with CAP were diagnosed with EGID.The median age of the children was 11.1 years(interquartile range=8.4-14.4).The estimated prevalence of EGID in children with organic CAP was 520/10000 children over 5 years.Periumbilical pain was the most common site(63%).Family history of atopy,peripheral blood eosinophilia,and elevated serum IgE were the three parameters significantly associated with EGID.Clinical remission was obtained in all children at 6 months.The 47%had microscopic remission and maintained remission until a 1-year follow-up.The 53%had a fluctuating clinical course after 6 months.CONCLUSION EGID beyond the esophagus is not an uncommon entity among the children of India.It can contribute significantly to the etiology of pediatric CAP.展开更多
Background:Allergic eosinophilic asthma(EA)and eosinophilic granulomatosis with polyangiitis(EGPA)share significant overlaps in both epidemiology and pathogenesis,suggesting a potential link between the two con-dition...Background:Allergic eosinophilic asthma(EA)and eosinophilic granulomatosis with polyangiitis(EGPA)share significant overlaps in both epidemiology and pathogenesis,suggesting a potential link between the two con-ditions.Despite these associations,the underlying molecular and cellular mechanisms driving their connection remain poorly understood.Methods:We retrieved GSE143303 of EA and GSE144302 of EGPA from the GEO database and conducted dif-ferential expression analysis as well as functional enrichment analysis to identify differentially expressed genes(DEGs)and potential pathogenic pathways.A protein-protein interaction(PPI)network was generated using the STRING database.Key hub genes were determined through cytoHubba.We added two publicly reported EA and EGPA-related transcriptome datasets,GSE117038 and GSE119136,for mutual verification.Subsequent valida-tion was performed via immune infiltration assessment utilizing CIBERSORT.Results:In total,267 DEGs were identified,in which HSP90AA1,HSPA8,CCND1,RPS20,CD74,RPL5,RPS6,RHOA,RPS3A and FLT3LG are the top 10 hub genes,while the antigen processing and presentation pathway and leukocyte cell-cell adhesion pathway were the potential influential pathways.Increased naïve B cells and M1 type of Macrophages were detected in EA patients through immune infiltration analysis.Conclusions:Utilizing bioinformatics techniques,this study is the initial investigation to uncover the shared mechanisms involving the antigen processing and presentation pathway and leukocyte adhesion pathways in the progression of both EA and EGPA.It may offer potential biomarkers for future studies on the underlying path-ogenesis and treatment of EA and EGPA as well as eosinophilia related co-morbidities.展开更多
Background:Hypereosinophilia(HE)is a rare disease characterized by an increase in eosinophils.Suplatast tosilate is a selective Th2 cytokine inhibitor.This case report presents the course and prognosis of a patient wi...Background:Hypereosinophilia(HE)is a rare disease characterized by an increase in eosinophils.Suplatast tosilate is a selective Th2 cytokine inhibitor.This case report presents the course and prognosis of a patient with hypereosinophilia treated with suplatast tosilate monotherapy.Case presentation:A 41-year-old female patient who complained of“Elevated blood eosinophils were found during physical examination for more than 2 months”visited the Allergy Department.The systematic screening results of parasites,autoantibodies spectrum,tumor markers,peripheral blood morphology analysis,and leukemia fusion gene(FIP1L1-PDGFRα)were all negative.Gastrointestinal endoscopy only indicated mild gastritis.The dust mites and multiple fungal mixtures were weakly positive in intradermal tests.Finally diagnosed HE.After treatment with suplatast tosilate 2 months of 100mg three times daily,the blood eosinophils decreased to normal.Then,maintenance treatment with 50mg three times a day for 3 months.And without recurrence during nearly five years of follow-up.Conclusion:The report indicates that suplatast tosilate can reduce peripheral blood eosinophils levels in patients with HE,and may be a reliable option for individualized treatment of HE.However,there is still no consensus on whether suplatast tosilate can be used as a first-line treatment or as an adjuvant therapy to reduce the corticosteroids dosage for patients with eosinophilia,and further research is needed.展开更多
Eosinophilic granulomatosis with polyangitis(EGPA)is a rare multi-system disease that presents significant diagnostic challenges due to its complexity and low incidence(White and Dubey,2023).It affects males and femal...Eosinophilic granulomatosis with polyangitis(EGPA)is a rare multi-system disease that presents significant diagnostic challenges due to its complexity and low incidence(White and Dubey,2023).It affects males and females equally,though males may exhibit more active disease at diagnosis and often require more aggressive treatment(Liu et al.,2023).The hallmark features of EGPA include delayed-onset asthma,eosinophilia in tissues and blood,and vasculitis affecting small to medium-sized arteries(White and Dubey,2023).EGPA falls under the category of antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV),whereas only about half of EGPA patients test positive for ANCA(Khoury et al.,2023).展开更多
Eosinophilic gastroenteritis (EG) is an uncommon disease characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal tract, and is usually associated with dyspepsia, diarrhea and peripheral eos...Eosinophilic gastroenteritis (EG) is an uncommon disease characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal tract, and is usually associated with dyspepsia, diarrhea and peripheral eosinophilia. Diffuse gastrointestinal tract and colonic involvement are uncommon. The endoscopic appearance may vary from normal to mucosal nodularity and ulceration. Gastrointestinal obstruction is unusual and is associated with predominantly muscular disease. We present five unusual cases of EG associated with gastric outlet and duodenal obstruction. Two cases presented with acute pancreatitis and one had a history of pancreatitis. Four cases responded well to medical therapy and one had recurrent gastric outlet obstruction that required surgery. Four out of the five cases had endoscopic and histological evidence of esophagitis and two had colitis. Two patients had ascites. These cases reaffirm that EG is a disorder with protean manifestations and may involve the entire gastrointestinal tract. Gastric outlet and/or small bowel obstruction is an important though uncommon presentation of EG. It may also present as esophagitis, gastritis with polypoid lesions, ulcers or erosions, colitis and pancreatitis and may mimic malignancy.展开更多
Eosinophilic gastroenteritis (EGE) in the adult is a distinctive pathologically-based disorder characterized by an eosinophil-predominant mucosal inflammatory process. Most often,the disorder is detected during endosc...Eosinophilic gastroenteritis (EGE) in the adult is a distinctive pathologically-based disorder characterized by an eosinophil-predominant mucosal inflammatory process. Most often,the disorder is detected during endoscopic investigation for abdominal pain or diarrhea. Other causes of gastric and intestinal mucosal eosinophilia require exclusion,including parasitic infections and drug-induced causes. Occasionally,the muscle wall or serosal surface may be involved. EGE appears to be more readily recognized,in large part,due to an evolution in the imaging methods used to evaluate abdominal pain and diarrhea,in particular,endoscopic imaging and mucosal biopsies. Def inition of EGE,however,may be diffi cult,as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not well standardized. Also,the eosinophilic inflammatory process may be either patchy or diffuse and the detection of the eosinophilic infiltrates may vary depending on the method of biopsy fixation. Treatment has traditionally focused on resolution of symptoms,and,in some instances,eosinophil quantification in pre-treatment and post-treatment biopsies. Future evaluation and treatment of EGE may depend on precise serological biomarkers to aid in defi nition of the long-term natural history of the disorder and its response to pharmacological or biological forms of therapy.展开更多
Eosinophils are multifunctional granulocytes that contribute to the initiation and modulation of inflammation.Accumulating evidence suggests that eosinophils are adaptable leukocytes that orchestrate the resolution of...Eosinophils are multifunctional granulocytes that contribute to the initiation and modulation of inflammation.Accumulating evidence suggests that eosinophils are adaptable leukocytes that orchestrate the resolution of inflammatory responses.The most prevalent chronic inflammatory illness,rheumatoid arthritis(RA),is typified by persistent synovitis thatmakes it hard for the disease to go away on its own.Interestingly,a unique subset of eosinophils known as regulatory eosinophils has been found in RA patients’synovium,especially while the disease is in remission.Pro-resolving signatures of regulatory eosinophils in the synovium are distinct from those of their lung counterparts.The most recent research on eosinophils and their function in this disease pathogenesis is compiled in this review.Based on the role of regulatory eosinophils,a new pathological model of inflammation resolution in RA is proposed,and potential therapeutic strategies aimed at enhancing the action of regulatory eosinophils in RA are proposed.展开更多
Eosinophilic myocarditis(EM)is a rare inflammatory condition of the heart,often associated with eosinophilic infiltration.While its causes range from allergies to autoimmune and infectious diseases,parasitic infection...Eosinophilic myocarditis(EM)is a rare inflammatory condition of the heart,often associated with eosinophilic infiltration.While its causes range from allergies to autoimmune and infectious diseases,parasitic infections are an uncommon but critical etiology.This mini-review focuses on a case of EM in a 47-year-old male from Vietnam,linked to Schistosoma spp.,Strongyloides stercoralis,and Toxocara spp.infections.The patient presented with severe chest pain and recovered fully after treatment with corticosteroids and albendazole.Drawing insights from this case and existing literature,we discuss the pathophysiology,diagnostic approaches,and therapeutic strategies for parasite-induced EM.Early diagnosis and tailored treatment are essential to improve clinical outcomes,especially in endemic para-sitic areas.展开更多
BACKGROUND Eosinophilic esophagitis(EoE)is a chronic inflammatory disorder presenting as symptoms of dysphagia,esophageal food impaction,chest pain,and heartburn.After an initial trial of proton pump inhibitor(PPI)the...BACKGROUND Eosinophilic esophagitis(EoE)is a chronic inflammatory disorder presenting as symptoms of dysphagia,esophageal food impaction,chest pain,and heartburn.After an initial trial of proton pump inhibitor(PPI)therapy,swallowed topical corticosteroids(STC)are effective as induction therapy for EoE.However,out-come data for STC as a maintenance strategy is limited.RESULTS Three randomized control trials and one observational study were included,involving 303 patients(189 in the STC group,114 in the placebo-controlled group).Analysis showed that histologic recurrence was significantly lower with STC(OR:0.04,95%CI:0.01-0.28,P<0.00001,I^(2)=78%).Overall symptom recurrence was similar between groups(OR:0.23,95%CI:0.02-3.54,P=0.29,I^(2)=92%).On sensitivity analysis,symptom recurrence was significantly lower in the STC group(OR:0.05,95%CI:0.02-0.17,P=0.00001,I^(2)=39%).Odds of repeat dilation were significantly lower in the STC group(OR:0.14,95%CI:0.02-0.91,P=0.04,I^(2)=0%).Candida infection rates were similar between groups(OR:6.13,95%CI:0.85-44.26,P=0.07,I^(2)=24%).Proportion of concomitant PPI use was similar between groups(OR:1.64,95%CI:0.83-3.21,P=0.15,I^(2)=0%).CONCLUSION For patients who successfully achieved remission of EoE with STC induction therapy,maintaining treatment is effective in sustaining histologic remission,while newer regimens may be effective in preventing symptom recurrence compared to placebo.We found no significant difference for oropharyngeal/esophageal candidiasis with STC maintenance therapy.Future studies with longer follow-up periods are needed.展开更多
Eosinophilic esophagitis(EoE)is a chronic,immune-mediated condition leading to esophageal inflammation and a range of symptomatic complications if inadequately managed.Recent epidemiological trends indicate a signific...Eosinophilic esophagitis(EoE)is a chronic,immune-mediated condition leading to esophageal inflammation and a range of symptomatic complications if inadequately managed.Recent epidemiological trends indicate a significant increase in EoE prevalence,complicating patient care amid diagnostic challenges associated with conventional methods such as endoscopy and histopathological analysis.This review explores the promise of artificial intelligence(AI)and deep learning models in enhancing the diagnosis and management of EoE,addressing the limitations of traditional approaches including inter-observer variability,invasiveness,and delays in diagnosis.By synthesizing findings from peer-reviewed studies,we demonstrate that AI algorithms exhibit high diagnostic accuracy in recognizing subtle endoscopic features and quantifying eosinophilic tissue infiltration.Moreover,these technologies can streamline workflows,reduce dependency on manual assessments,and enhance personalized care strategies.Despite the potential benefits,challenges regarding the integration of AI into clinical practice remain,including issues of algorithmic bias,data privacy,and the need for robust validation across diverse healthcare settings.Future research should focus on multicenter studies to confirm AI’s effectiveness,explore non-invasive diagnostic alternatives,and promote the ethical application of AI to optimize patient outcomes in EoE.This review highlights AI’s transformative capacity to reshape the diagnostic landscape of EoE,underscoring the requirement for ongoing evaluation and collaboration among clinicians,researchers,and technology developers to realize its full potential within the healthcare framework.展开更多
Precise risk stratification is crucial for selecting the optimal risk-adapted treatment for newly diagnosed multiple myeloma (NDMM) patients. Various prognostic factors and staging systems have been developed to predi...Precise risk stratification is crucial for selecting the optimal risk-adapted treatment for newly diagnosed multiple myeloma (NDMM) patients. Various prognostic factors and staging systems have been developed to predict NDMM patient outcomes. The Durie-Salmon (D-S) staging system reflects tumor burden and clinical progression staging with prognostic value.展开更多
Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophi...Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophilic pneumonia include smoking, environmental irritants or inhalants and certain medications such as Daptomycin [1]. In this review of literature, we aim to explore the potential triggers for developing acute eosinophilic pneumonia in patients exposed to Daptomycin. The exact immune mechanism for daptomycin induced AEP is unknown, however the current proposed mechanism describes a T helper 2 lymphocyte response to inactivated daptomycin in the pulmonary surfactant, which leads to eosinophilia. Disordered T regulatory cell function is seen in patients with certain cancers, allergies and autoimmune conditions. We propose that patients with these underlying risk factors may be at increased risk of developing AEP after becoming exposed to Daptomycin. Understanding potential risk factors is crucial for health care workers as it allows them to identify susceptible populations, explore preventative measures and treat accordingly.展开更多
Introduction： EoE （eosinophilic esophagitis） is an inflammatory condition characterized by a dense eosinophilic infiltrate in the esophageal epithelium. In Brazil, it remains a poorly diagnosed disease due to the l...Introduction： EoE （eosinophilic esophagitis） is an inflammatory condition characterized by a dense eosinophilic infiltrate in the esophageal epithelium. In Brazil, it remains a poorly diagnosed disease due to the lack of interaction between the clinician, the endoscopist, and the pathologist. The diagnosis is performed by histological study of esophageal biopsies, with at least fifteen eosinophils per high-power field （EOS/HPF）. Some doubts remain with respect to patients with a clinical picture and symptoms compatible with the disease （EoE）, but who have a lower number of eosinophils than established. The main objective of this study was to create an endoscopic classification for EsEo （esophageal eosinophilia）, which pointed the way to the endoscopist towards the diagnosis. Methods： This study was a prospective, two-year study, at a gastrointestinal endoscopy center where all patients with endoscopic symptoms and/or endoscopic findings suggestive of EsEo were biopsied for histological examination of EOS/HPF. After the study and compilation of the results, a retrospective study was performed, based on a review of electronic medical records, where the same diagnosis was searched, although at a period when this classification was not adopted. Results： A total of 4,251 endoscopies were performed between September 2011 and September 2013. Two biopsies were performed, aimed at lesions, in 133 patients with clinical picture or imaging suggestive of EsEo. Eosinophils were found in 55 patients, corresponding to an incidence of 1.29% of the total population studied and 41.35% of the suspected cases of the disease. EoE was diagnosed in 24 patients during the period of this study. In the two-year retrospective study, only two cases of EoE were found. Conclusions： The results of this study demonstrate that the endoscopic standardization of esophageal lesions, suggestive of eosinophilia, in this case by classification, alerts the endoscopist for the diagnosis of EoE, prompting him to perform targeted biopsies. Further, it was observed that two samples of esophageal tissue were sufficient for the diagnosis. The relationship between the clinical picture, endoscopy, and histology was not evident in this study.展开更多
Chronic eosinophilic leukemia (CEL) is a rare disorder that is characterized by hypereosinophilia with increased number of blood or marrow blasts (>5% and <20%). CEL is distinguished from hypereosinophilic syndr...Chronic eosinophilic leukemia (CEL) is a rare disorder that is characterized by hypereosinophilia with increased number of blood or marrow blasts (>5% and <20%). CEL is distinguished from hypereosinophilic syndrome (HES) by the presence of eosinophilic clonality. Chronic eosinophilic leukemia not otherwise specified (CEL-NOS) diagnosis is made when no fusion genes are detected by most modern molecular testing, particularly the most common fusion gene FIP1L-1/PDGFRA (Factor Interacting with PAP like-1/Platelet-Derived Growth Factor Receptor Alpha). This disease is very rare, and its description in the literature is not well characterized. We report a fetal case of severe CEL-NOS in a 19-year-old male who presented with a plethora of clinical features consists of constitutional symptoms, pancytopenia, intravascular thrombosis, acute stroke and endomyocardial infiltrates. The course of his disease was aggressive and resistant to conventional treatment. After a short period of improvement, an acute transformation into blast crisis (BC) had occurred. The diagnosis was confirmed by morphology and immunophenotyping of bone marrow biopsy. The patient eventually died of heart failure and sepsis. To our knowledge this is the first case report of fatal CEL-NOS transforming into severe blast crisis.展开更多
Introduction:Eosinophilia is a rare disease characterized by an increase in eosinophils.Suplatast tosilate is a selective Th2 cytokine inhibitor that can reduce eosinophils.There is currently a lack of clinical studie...Introduction:Eosinophilia is a rare disease characterized by an increase in eosinophils.Suplatast tosilate is a selective Th2 cytokine inhibitor that can reduce eosinophils.There is currently a lack of clinical studies of suplatast tosilate in the treatment of eosinophilia.Research objective:To explore whether suplatast tosilate can reduce blood eosinophil levels in eosinophilia and the factors that might influence the improvement.Methods:A real-world retrospective study of 20 patients with eosinophilia was conducted using electronic medical record information.The main outcome measure was the difference in peripheral blood absolute eosinophil count(AEC)and percentage(EOS%)before suplatast tosilate(baseline)and the lowest AEC during the 1-year period of suplatast tosilate treatment(post-treatment).Data on age,gender,disease duration,involved organs,and concomitant medication were collected,and subgroup analysis and linear regression analysis were performed.Results:Subjects were predominantly male,with a mean age of 33 years and a disease duration of approximately 30 months.After treatment with suplatast tosilate,the patient's AEC(p=0.029)and EOS%(p=0.016)significantly decreased.The decline in eosinophils was more pronounced in patients who were male,age<33 years,disease duration<30 months and gastrointestinal system involvement.In addition,the shorter the course of the disease,the greater the relative decrease in eosinophils after suplatast tosilate treatment(β=-0.018,p<0.001).Conclusions:Suplatast tosilate is effective in reducing peripheral blood eosinophil levels in patients with eosinophilia.Large-scale prospective cohort studies are needed for further confirmation.展开更多
Chronic rhinosinusitis(CRS) is a common disease worldwide, with a prevalence rate of 5%-15% in the general population. CRS is currently classified into two types: CRS with and without nasal polyps. CRS may also be div...Chronic rhinosinusitis(CRS) is a common disease worldwide, with a prevalence rate of 5%-15% in the general population. CRS is currently classified into two types: CRS with and without nasal polyps. CRS may also be divided into eosinophilic CRS(ECRS) and non-ECRS subtypes based on the presence of tissue eosinophilic infiltration or not. There are significant geographic and ethnic differences in the tissue eosinophilic infiltration, which is predominant in Western white patients and less common in East Asians, despite an increasing tendency for its prevalence in East Asia countries. ECRS differs significantly from non-ECRS in clinical characteristics, treatment outcomes and strategies, and underlying pathogenic mechanisms. ECRS commonly demonstrates more severe symptoms, polyp diseases with a higher incidence of bilateral polyps and sinonasal diseases on computed tomography, and the increase in blood eosinophils. ECRS is considered a special and recalcitrant subtype of CRS, commonly with poor treatment outcomes compared to non-ECRS. The differentiation of specific subtypes and clinical features of CRS will be important for developing novel treatment strategies and improving treatment outcomes for individual phenotypes of CRS. This review discusses clinical features, diagnosis, treatment and prognosis of ECRS in East Asians.展开更多
AIM To analyze the clinical characteristics of eosinophilic gastroenteritis(EGE)and to investigate the situations of missed diagnosis of EGE.METHODS First,the clinical characteristics of 20 EGE patients who were treat...AIM To analyze the clinical characteristics of eosinophilic gastroenteritis(EGE)and to investigate the situations of missed diagnosis of EGE.METHODS First,the clinical characteristics of 20 EGE patients who were treated at our hospital were retrospectively summarized.Second,159 patients who underwent gastroscopy and 211 patients who underwent colonoscopy were enrolled.The pathological diagnosis showed only chronic inflammation in their medical records.The biopsy slides of these patients were reevaluated to determine the number of infiltrating eosinophils in order to assess the probability of a missed diagnosis of EGE.Finally,122 patients who experienced refractory upper gastrointestinal symptoms for at least one month were recruited.At least 6biopsy specimens were obtained by gastroscopy,and the number of eosinophils that had infiltrated was evaluated.Those who met the pathological diagnostic criteria of EGE underwent further examination to confirm the diagnosis of EGE.The probability of a missed diagnosis of EGE was prospectively investigated.RESULTS Among the 20 patients with EGE,mucosal EGE was found in 15 patients,muscular EGE was found in 3patients and serosal EGE was found in 2 patients.Abdominal pain was the most common symptom.The number of peripheral blood eosinophils was elevated in all 20 patients,all of whom were sensitive to corticosteroids.Second,among the 159 patients who underwent gastroscopy,7(4.40%)patients met the criteria for pathological EGE(eosinophil count≥25/HPF).Among the 211 patients who underwent colonoscopy,9(4.27%)patients met the criteria for pathological EGE(eosinophil count≥30/HPF).No patients with eosinophil infiltration were diagnosed with EGE in clinical practice before or after endoscopy.Although these patients did not undergo further examination to exclude other diseases that can also lead to gastrointestinal eosinophil infiltration,these might be the cases where the diagnosis of EGE was missed.Finally,among the 122 patients with refractory upper gastrointestinal symptoms,eosinophil infiltration was seen in 7 patients(5.74%).The diagnosis of EGE was confirmed in all 7 patients after the exclusion of other diseases that can also lead to gastrointestinal eosinophil infiltration.A positive correlation was observed between the duration of the symptoms and the risk of EGE(r=0.18,P<0.01).The patients whose symptoms persisted longer than 6 mo more readily developed EGE.None of the patients were considered to have EGE by their physicians before endoscopy.CONCLUSION Although EGE is a rare inflammatory disorder,it is easily misdiagnosed.When a long history of abdominal symptoms fails to improve after conventional therapy,EGE should be considered.展开更多
基金supported by the Anhui Provincial Health and Medical Research Project (AHWJ2023A30277)。
文摘Acute eosinophilic pneumonia(AEP) is a pulmonary condition characterized by acute febrile illness and respiratory distress,with bilateral pulmonary infiltrates,particularly eosinophilic infiltration of the lungs.^([1])Amiodarone,a widely applied antiarrhythmic agent,has been reported as a potential cause of drug-induced AEP.^([2]) Most reported cases of amiodarone-induced AEP typically occur following prolonged exposure for two months or more.
文摘BACKGROUND Hepatic eosinophilic pseudotumor(HEPT)is a rare condition that mimics ma-lignant hepatic tumors,posing significant diagnostic challenges.This case report highlights the importance of considering parasitic infections like Fasciola hepatica(F.hepatica)in the differential diagnosis of hepatic masses,especially in endemic regions,to prevent unnecessary interventions.CASE SUMMARY A 40-year-old female presented with a 1-month history of epigastric pain and significant weight loss.Imaging revealed a hepatic mass,initially misdiagnosed as intrahepatic cholangiocarcinoma.Laboratory results showed marked eosinophilia,and histopathological examination confirmed significant eosinophilic infiltration without malignancy.Serological testing identified F.hepatica infection.The patient was treated with a single dose of triclabendazole,leading to complete symptom resolution and normalization of hepatic imaging findings within days.CONCLUSION HEPT due to F.hepatica can closely mimic malignancy;timely antiparasitic treat-ment is crucial for resolution.
文摘1.Introduction Eosinophils are granulocytes derived from bone marrow and are typically present in low numbers in the peripheral blood of healthy individuals[1].They originate from CD34+hematopoietic stem cells in the bone marrow.In type 2 inflammatory conditions,bone marrow eosinopoiesis increases,leading to a higher release of mature eosinophils into the bloodstream[1].Once in circulation,eosinophils can migrate to various tissues and organs under both physiologic and pathological conditions.During eosinophilopoiesis.
文摘BACKGROUND Eosinophilic gastrointestinal(GI)disease(EGID)beyond eosinophilic esophagitis is not commonly reported in the developing world.AIM To estimate the prevalence of EGID in a selected group of pediatric patients suffering from non-functional chronic abdominal pain(CAP).METHODS A retrospective analysis was conducted on case records of children with CAP.Those exhibiting clinical or laboratory alarming features underwent endoscopic evaluation.Histopathology reports from upper GI endoscopy and ileo-colonoscopy determined the diagnosis of EGID.Subsequent analyses included clinical presentations,presence of atopy in the children or family,hemoglobin,albumin,serum immunoglobulin E(IgE),fecal calprotectin levels,endoscopic appearances,treatment methods,and outcomes.RESULTS A total of 368 children with organic CAP were subjected to endoscopic evaluation.Among them,19(5.2%)patients with CAP were diagnosed with EGID.The median age of the children was 11.1 years(interquartile range=8.4-14.4).The estimated prevalence of EGID in children with organic CAP was 520/10000 children over 5 years.Periumbilical pain was the most common site(63%).Family history of atopy,peripheral blood eosinophilia,and elevated serum IgE were the three parameters significantly associated with EGID.Clinical remission was obtained in all children at 6 months.The 47%had microscopic remission and maintained remission until a 1-year follow-up.The 53%had a fluctuating clinical course after 6 months.CONCLUSION EGID beyond the esophagus is not an uncommon entity among the children of India.It can contribute significantly to the etiology of pediatric CAP.
基金funded by National Natural Science Foundation of China(NO.82370083).
文摘Background:Allergic eosinophilic asthma(EA)and eosinophilic granulomatosis with polyangiitis(EGPA)share significant overlaps in both epidemiology and pathogenesis,suggesting a potential link between the two con-ditions.Despite these associations,the underlying molecular and cellular mechanisms driving their connection remain poorly understood.Methods:We retrieved GSE143303 of EA and GSE144302 of EGPA from the GEO database and conducted dif-ferential expression analysis as well as functional enrichment analysis to identify differentially expressed genes(DEGs)and potential pathogenic pathways.A protein-protein interaction(PPI)network was generated using the STRING database.Key hub genes were determined through cytoHubba.We added two publicly reported EA and EGPA-related transcriptome datasets,GSE117038 and GSE119136,for mutual verification.Subsequent valida-tion was performed via immune infiltration assessment utilizing CIBERSORT.Results:In total,267 DEGs were identified,in which HSP90AA1,HSPA8,CCND1,RPS20,CD74,RPL5,RPS6,RHOA,RPS3A and FLT3LG are the top 10 hub genes,while the antigen processing and presentation pathway and leukocyte cell-cell adhesion pathway were the potential influential pathways.Increased naïve B cells and M1 type of Macrophages were detected in EA patients through immune infiltration analysis.Conclusions:Utilizing bioinformatics techniques,this study is the initial investigation to uncover the shared mechanisms involving the antigen processing and presentation pathway and leukocyte adhesion pathways in the progression of both EA and EGPA.It may offer potential biomarkers for future studies on the underlying path-ogenesis and treatment of EA and EGPA as well as eosinophilia related co-morbidities.
基金supported by the National High-Level Hospital Clinical Research Funding(2022-PUMCH-D-002).
文摘Background:Hypereosinophilia(HE)is a rare disease characterized by an increase in eosinophils.Suplatast tosilate is a selective Th2 cytokine inhibitor.This case report presents the course and prognosis of a patient with hypereosinophilia treated with suplatast tosilate monotherapy.Case presentation:A 41-year-old female patient who complained of“Elevated blood eosinophils were found during physical examination for more than 2 months”visited the Allergy Department.The systematic screening results of parasites,autoantibodies spectrum,tumor markers,peripheral blood morphology analysis,and leukemia fusion gene(FIP1L1-PDGFRα)were all negative.Gastrointestinal endoscopy only indicated mild gastritis.The dust mites and multiple fungal mixtures were weakly positive in intradermal tests.Finally diagnosed HE.After treatment with suplatast tosilate 2 months of 100mg three times daily,the blood eosinophils decreased to normal.Then,maintenance treatment with 50mg three times a day for 3 months.And without recurrence during nearly five years of follow-up.Conclusion:The report indicates that suplatast tosilate can reduce peripheral blood eosinophils levels in patients with HE,and may be a reliable option for individualized treatment of HE.However,there is still no consensus on whether suplatast tosilate can be used as a first-line treatment or as an adjuvant therapy to reduce the corticosteroids dosage for patients with eosinophilia,and further research is needed.
基金supported by the National Natural Science Foundation of China(No.82070200)。
文摘Eosinophilic granulomatosis with polyangitis(EGPA)is a rare multi-system disease that presents significant diagnostic challenges due to its complexity and low incidence(White and Dubey,2023).It affects males and females equally,though males may exhibit more active disease at diagnosis and often require more aggressive treatment(Liu et al.,2023).The hallmark features of EGPA include delayed-onset asthma,eosinophilia in tissues and blood,and vasculitis affecting small to medium-sized arteries(White and Dubey,2023).EGPA falls under the category of antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV),whereas only about half of EGPA patients test positive for ANCA(Khoury et al.,2023).
文摘Eosinophilic gastroenteritis (EG) is an uncommon disease characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal tract, and is usually associated with dyspepsia, diarrhea and peripheral eosinophilia. Diffuse gastrointestinal tract and colonic involvement are uncommon. The endoscopic appearance may vary from normal to mucosal nodularity and ulceration. Gastrointestinal obstruction is unusual and is associated with predominantly muscular disease. We present five unusual cases of EG associated with gastric outlet and duodenal obstruction. Two cases presented with acute pancreatitis and one had a history of pancreatitis. Four cases responded well to medical therapy and one had recurrent gastric outlet obstruction that required surgery. Four out of the five cases had endoscopic and histological evidence of esophagitis and two had colitis. Two patients had ascites. These cases reaffirm that EG is a disorder with protean manifestations and may involve the entire gastrointestinal tract. Gastric outlet and/or small bowel obstruction is an important though uncommon presentation of EG. It may also present as esophagitis, gastritis with polypoid lesions, ulcers or erosions, colitis and pancreatitis and may mimic malignancy.
文摘Eosinophilic gastroenteritis (EGE) in the adult is a distinctive pathologically-based disorder characterized by an eosinophil-predominant mucosal inflammatory process. Most often,the disorder is detected during endoscopic investigation for abdominal pain or diarrhea. Other causes of gastric and intestinal mucosal eosinophilia require exclusion,including parasitic infections and drug-induced causes. Occasionally,the muscle wall or serosal surface may be involved. EGE appears to be more readily recognized,in large part,due to an evolution in the imaging methods used to evaluate abdominal pain and diarrhea,in particular,endoscopic imaging and mucosal biopsies. Def inition of EGE,however,may be diffi cult,as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not well standardized. Also,the eosinophilic inflammatory process may be either patchy or diffuse and the detection of the eosinophilic infiltrates may vary depending on the method of biopsy fixation. Treatment has traditionally focused on resolution of symptoms,and,in some instances,eosinophil quantification in pre-treatment and post-treatment biopsies. Future evaluation and treatment of EGE may depend on precise serological biomarkers to aid in defi nition of the long-term natural history of the disorder and its response to pharmacological or biological forms of therapy.
基金supported by NIH grants to M Bukrinsky P30 AI117970by the“Creation of Experimental Laboratories in the Natural Sciences Program”and Basic Research Program at the Higher School of Economics University.
文摘Eosinophils are multifunctional granulocytes that contribute to the initiation and modulation of inflammation.Accumulating evidence suggests that eosinophils are adaptable leukocytes that orchestrate the resolution of inflammatory responses.The most prevalent chronic inflammatory illness,rheumatoid arthritis(RA),is typified by persistent synovitis thatmakes it hard for the disease to go away on its own.Interestingly,a unique subset of eosinophils known as regulatory eosinophils has been found in RA patients’synovium,especially while the disease is in remission.Pro-resolving signatures of regulatory eosinophils in the synovium are distinct from those of their lung counterparts.The most recent research on eosinophils and their function in this disease pathogenesis is compiled in this review.Based on the role of regulatory eosinophils,a new pathological model of inflammation resolution in RA is proposed,and potential therapeutic strategies aimed at enhancing the action of regulatory eosinophils in RA are proposed.
文摘Eosinophilic myocarditis(EM)is a rare inflammatory condition of the heart,often associated with eosinophilic infiltration.While its causes range from allergies to autoimmune and infectious diseases,parasitic infections are an uncommon but critical etiology.This mini-review focuses on a case of EM in a 47-year-old male from Vietnam,linked to Schistosoma spp.,Strongyloides stercoralis,and Toxocara spp.infections.The patient presented with severe chest pain and recovered fully after treatment with corticosteroids and albendazole.Drawing insights from this case and existing literature,we discuss the pathophysiology,diagnostic approaches,and therapeutic strategies for parasite-induced EM.Early diagnosis and tailored treatment are essential to improve clinical outcomes,especially in endemic para-sitic areas.
文摘BACKGROUND Eosinophilic esophagitis(EoE)is a chronic inflammatory disorder presenting as symptoms of dysphagia,esophageal food impaction,chest pain,and heartburn.After an initial trial of proton pump inhibitor(PPI)therapy,swallowed topical corticosteroids(STC)are effective as induction therapy for EoE.However,out-come data for STC as a maintenance strategy is limited.RESULTS Three randomized control trials and one observational study were included,involving 303 patients(189 in the STC group,114 in the placebo-controlled group).Analysis showed that histologic recurrence was significantly lower with STC(OR:0.04,95%CI:0.01-0.28,P<0.00001,I^(2)=78%).Overall symptom recurrence was similar between groups(OR:0.23,95%CI:0.02-3.54,P=0.29,I^(2)=92%).On sensitivity analysis,symptom recurrence was significantly lower in the STC group(OR:0.05,95%CI:0.02-0.17,P=0.00001,I^(2)=39%).Odds of repeat dilation were significantly lower in the STC group(OR:0.14,95%CI:0.02-0.91,P=0.04,I^(2)=0%).Candida infection rates were similar between groups(OR:6.13,95%CI:0.85-44.26,P=0.07,I^(2)=24%).Proportion of concomitant PPI use was similar between groups(OR:1.64,95%CI:0.83-3.21,P=0.15,I^(2)=0%).CONCLUSION For patients who successfully achieved remission of EoE with STC induction therapy,maintaining treatment is effective in sustaining histologic remission,while newer regimens may be effective in preventing symptom recurrence compared to placebo.We found no significant difference for oropharyngeal/esophageal candidiasis with STC maintenance therapy.Future studies with longer follow-up periods are needed.
文摘Eosinophilic esophagitis(EoE)is a chronic,immune-mediated condition leading to esophageal inflammation and a range of symptomatic complications if inadequately managed.Recent epidemiological trends indicate a significant increase in EoE prevalence,complicating patient care amid diagnostic challenges associated with conventional methods such as endoscopy and histopathological analysis.This review explores the promise of artificial intelligence(AI)and deep learning models in enhancing the diagnosis and management of EoE,addressing the limitations of traditional approaches including inter-observer variability,invasiveness,and delays in diagnosis.By synthesizing findings from peer-reviewed studies,we demonstrate that AI algorithms exhibit high diagnostic accuracy in recognizing subtle endoscopic features and quantifying eosinophilic tissue infiltration.Moreover,these technologies can streamline workflows,reduce dependency on manual assessments,and enhance personalized care strategies.Despite the potential benefits,challenges regarding the integration of AI into clinical practice remain,including issues of algorithmic bias,data privacy,and the need for robust validation across diverse healthcare settings.Future research should focus on multicenter studies to confirm AI’s effectiveness,explore non-invasive diagnostic alternatives,and promote the ethical application of AI to optimize patient outcomes in EoE.This review highlights AI’s transformative capacity to reshape the diagnostic landscape of EoE,underscoring the requirement for ongoing evaluation and collaboration among clinicians,researchers,and technology developers to realize its full potential within the healthcare framework.
基金supported by the National Natural Science Foundation of China (Grant nos. 82470209 and 82170141)the Jiaxing Key Discipiline of Medcine-Nephrology (Grant no. 2023-ZC-011)。
文摘Precise risk stratification is crucial for selecting the optimal risk-adapted treatment for newly diagnosed multiple myeloma (NDMM) patients. Various prognostic factors and staging systems have been developed to predict NDMM patient outcomes. The Durie-Salmon (D-S) staging system reflects tumor burden and clinical progression staging with prognostic value.
文摘Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophilic pneumonia include smoking, environmental irritants or inhalants and certain medications such as Daptomycin [1]. In this review of literature, we aim to explore the potential triggers for developing acute eosinophilic pneumonia in patients exposed to Daptomycin. The exact immune mechanism for daptomycin induced AEP is unknown, however the current proposed mechanism describes a T helper 2 lymphocyte response to inactivated daptomycin in the pulmonary surfactant, which leads to eosinophilia. Disordered T regulatory cell function is seen in patients with certain cancers, allergies and autoimmune conditions. We propose that patients with these underlying risk factors may be at increased risk of developing AEP after becoming exposed to Daptomycin. Understanding potential risk factors is crucial for health care workers as it allows them to identify susceptible populations, explore preventative measures and treat accordingly.
文摘Introduction： EoE （eosinophilic esophagitis） is an inflammatory condition characterized by a dense eosinophilic infiltrate in the esophageal epithelium. In Brazil, it remains a poorly diagnosed disease due to the lack of interaction between the clinician, the endoscopist, and the pathologist. The diagnosis is performed by histological study of esophageal biopsies, with at least fifteen eosinophils per high-power field （EOS/HPF）. Some doubts remain with respect to patients with a clinical picture and symptoms compatible with the disease （EoE）, but who have a lower number of eosinophils than established. The main objective of this study was to create an endoscopic classification for EsEo （esophageal eosinophilia）, which pointed the way to the endoscopist towards the diagnosis. Methods： This study was a prospective, two-year study, at a gastrointestinal endoscopy center where all patients with endoscopic symptoms and/or endoscopic findings suggestive of EsEo were biopsied for histological examination of EOS/HPF. After the study and compilation of the results, a retrospective study was performed, based on a review of electronic medical records, where the same diagnosis was searched, although at a period when this classification was not adopted. Results： A total of 4,251 endoscopies were performed between September 2011 and September 2013. Two biopsies were performed, aimed at lesions, in 133 patients with clinical picture or imaging suggestive of EsEo. Eosinophils were found in 55 patients, corresponding to an incidence of 1.29% of the total population studied and 41.35% of the suspected cases of the disease. EoE was diagnosed in 24 patients during the period of this study. In the two-year retrospective study, only two cases of EoE were found. Conclusions： The results of this study demonstrate that the endoscopic standardization of esophageal lesions, suggestive of eosinophilia, in this case by classification, alerts the endoscopist for the diagnosis of EoE, prompting him to perform targeted biopsies. Further, it was observed that two samples of esophageal tissue were sufficient for the diagnosis. The relationship between the clinical picture, endoscopy, and histology was not evident in this study.
文摘Chronic eosinophilic leukemia (CEL) is a rare disorder that is characterized by hypereosinophilia with increased number of blood or marrow blasts (>5% and <20%). CEL is distinguished from hypereosinophilic syndrome (HES) by the presence of eosinophilic clonality. Chronic eosinophilic leukemia not otherwise specified (CEL-NOS) diagnosis is made when no fusion genes are detected by most modern molecular testing, particularly the most common fusion gene FIP1L-1/PDGFRA (Factor Interacting with PAP like-1/Platelet-Derived Growth Factor Receptor Alpha). This disease is very rare, and its description in the literature is not well characterized. We report a fetal case of severe CEL-NOS in a 19-year-old male who presented with a plethora of clinical features consists of constitutional symptoms, pancytopenia, intravascular thrombosis, acute stroke and endomyocardial infiltrates. The course of his disease was aggressive and resistant to conventional treatment. After a short period of improvement, an acute transformation into blast crisis (BC) had occurred. The diagnosis was confirmed by morphology and immunophenotyping of bone marrow biopsy. The patient eventually died of heart failure and sepsis. To our knowledge this is the first case report of fatal CEL-NOS transforming into severe blast crisis.
基金supported by Clinical Research Operating Fund of Central High Level Hospitals(2022-PUMCH-D-002).
文摘Introduction:Eosinophilia is a rare disease characterized by an increase in eosinophils.Suplatast tosilate is a selective Th2 cytokine inhibitor that can reduce eosinophils.There is currently a lack of clinical studies of suplatast tosilate in the treatment of eosinophilia.Research objective:To explore whether suplatast tosilate can reduce blood eosinophil levels in eosinophilia and the factors that might influence the improvement.Methods:A real-world retrospective study of 20 patients with eosinophilia was conducted using electronic medical record information.The main outcome measure was the difference in peripheral blood absolute eosinophil count(AEC)and percentage(EOS%)before suplatast tosilate(baseline)and the lowest AEC during the 1-year period of suplatast tosilate treatment(post-treatment).Data on age,gender,disease duration,involved organs,and concomitant medication were collected,and subgroup analysis and linear regression analysis were performed.Results:Subjects were predominantly male,with a mean age of 33 years and a disease duration of approximately 30 months.After treatment with suplatast tosilate,the patient's AEC(p=0.029)and EOS%(p=0.016)significantly decreased.The decline in eosinophils was more pronounced in patients who were male,age<33 years,disease duration<30 months and gastrointestinal system involvement.In addition,the shorter the course of the disease,the greater the relative decrease in eosinophils after suplatast tosilate treatment(β=-0.018,p<0.001).Conclusions:Suplatast tosilate is effective in reducing peripheral blood eosinophil levels in patients with eosinophilia.Large-scale prospective cohort studies are needed for further confirmation.
文摘Chronic rhinosinusitis(CRS) is a common disease worldwide, with a prevalence rate of 5%-15% in the general population. CRS is currently classified into two types: CRS with and without nasal polyps. CRS may also be divided into eosinophilic CRS(ECRS) and non-ECRS subtypes based on the presence of tissue eosinophilic infiltration or not. There are significant geographic and ethnic differences in the tissue eosinophilic infiltration, which is predominant in Western white patients and less common in East Asians, despite an increasing tendency for its prevalence in East Asia countries. ECRS differs significantly from non-ECRS in clinical characteristics, treatment outcomes and strategies, and underlying pathogenic mechanisms. ECRS commonly demonstrates more severe symptoms, polyp diseases with a higher incidence of bilateral polyps and sinonasal diseases on computed tomography, and the increase in blood eosinophils. ECRS is considered a special and recalcitrant subtype of CRS, commonly with poor treatment outcomes compared to non-ECRS. The differentiation of specific subtypes and clinical features of CRS will be important for developing novel treatment strategies and improving treatment outcomes for individual phenotypes of CRS. This review discusses clinical features, diagnosis, treatment and prognosis of ECRS in East Asians.
基金Supported by Guangdong Science and Technology Program,No.2016A020216012
文摘AIM To analyze the clinical characteristics of eosinophilic gastroenteritis(EGE)and to investigate the situations of missed diagnosis of EGE.METHODS First,the clinical characteristics of 20 EGE patients who were treated at our hospital were retrospectively summarized.Second,159 patients who underwent gastroscopy and 211 patients who underwent colonoscopy were enrolled.The pathological diagnosis showed only chronic inflammation in their medical records.The biopsy slides of these patients were reevaluated to determine the number of infiltrating eosinophils in order to assess the probability of a missed diagnosis of EGE.Finally,122 patients who experienced refractory upper gastrointestinal symptoms for at least one month were recruited.At least 6biopsy specimens were obtained by gastroscopy,and the number of eosinophils that had infiltrated was evaluated.Those who met the pathological diagnostic criteria of EGE underwent further examination to confirm the diagnosis of EGE.The probability of a missed diagnosis of EGE was prospectively investigated.RESULTS Among the 20 patients with EGE,mucosal EGE was found in 15 patients,muscular EGE was found in 3patients and serosal EGE was found in 2 patients.Abdominal pain was the most common symptom.The number of peripheral blood eosinophils was elevated in all 20 patients,all of whom were sensitive to corticosteroids.Second,among the 159 patients who underwent gastroscopy,7(4.40%)patients met the criteria for pathological EGE(eosinophil count≥25/HPF).Among the 211 patients who underwent colonoscopy,9(4.27%)patients met the criteria for pathological EGE(eosinophil count≥30/HPF).No patients with eosinophil infiltration were diagnosed with EGE in clinical practice before or after endoscopy.Although these patients did not undergo further examination to exclude other diseases that can also lead to gastrointestinal eosinophil infiltration,these might be the cases where the diagnosis of EGE was missed.Finally,among the 122 patients with refractory upper gastrointestinal symptoms,eosinophil infiltration was seen in 7 patients(5.74%).The diagnosis of EGE was confirmed in all 7 patients after the exclusion of other diseases that can also lead to gastrointestinal eosinophil infiltration.A positive correlation was observed between the duration of the symptoms and the risk of EGE(r=0.18,P<0.01).The patients whose symptoms persisted longer than 6 mo more readily developed EGE.None of the patients were considered to have EGE by their physicians before endoscopy.CONCLUSION Although EGE is a rare inflammatory disorder,it is easily misdiagnosed.When a long history of abdominal symptoms fails to improve after conventional therapy,EGE should be considered.
