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18257

Case 2-2013: Eosinophilic Ascites (EA); Pathophysiology, Differential Diagnosis and Therapeutic Challenges

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Last updated: 03 Jan 2025

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Tags

Gastroenetrology

Abstract

The Eosinophilic ascites (EA) is a rare disorder of unknown etiology that has been reported in both adult and pediatric patients. It is a part of the eosinophilic gastroenteritis (EGE) syndrome, which is characterized by the presence of non specific abdominal complaints in association with eosinophil-driven inflammation of any or all layers of the gut wall. Peripheral eosinophilia may or may not be present. Here, we report a case of EA, a rare presentation of the serosal variant of EGE that developed in a thirty years old Egyptian female. She complained initially from nonspecific GI symptoms associated with diffuse abdominal pain and distention for several weeks. Her physical examination was significant for moderate ascites. Initial work-up demonstrated: very high peripheral eosinophilia, normal liver function tests, thickening of the small and large bowel walls, and normal total serum IgE. Upper endoscopy and extensive testing for malignancy and parasitic infections failed to establish a diagnosis. Ascetic fluid analysis showed significant eosinophilia. Further, a duodenal biopsy showed marked eosinophilic infiltration of the lamina Propria. This report adds to the scarce data on serosal involvement, "the rarest form of presentation" and illustrates that EGE complicated by ascites can be effectively treated with a combination therapy of steroids and the leukotriene receptor antagonist "Montelukast" after other systemic disorders associated with peripheral eosinophilia have been ruled out. The pathophysiology, differential diagnosis as well as therapeutic challenges associated with EGE are discussed

DOI

10.21608/aeji.2013.18257

Keywords

ascites, Eosinophilic gastroenteritis, EGE, Eosinophilic ascites, EA, Montelukast, steroids

Authors

First Name

Walid

Last Name

Abd Eldayem

MiddleName

A.

Affiliation

Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt

Email

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City

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Orcid

-

First Name

Ahmad

Last Name

Sherbini

MiddleName

S

Affiliation

Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt

Email

-

City

-

Orcid

-

Volume

3

Article Issue

4

Related Issue

3785

Issue Date

2013-12-01

Receive Date

2013-12-02

Publish Date

2013-12-14

Page Start

146

Page End

152

Print ISSN

2090-7613

Online ISSN

2090-7184

Article File

AEJI_Volume 3_Issue 4_Pages 146-152.pdf

PDF . 205.5kB

Link

https://aeji.journals.ekb.eg/article_18257.html

Detail API

https://aeji.journals.ekb.eg/service?article_code=18257

Order

6

Type

Case report

Type Code

622

Publication Type

Journal

Publication Title

Afro-Egyptian Journal of Infectious and Endemic Diseases

Publication Link

https://aeji.journals.ekb.eg/

MainTitle

Case 2-2013: Eosinophilic Ascites (EA); Pathophysiology, Differential Diagnosis and Therapeutic Challenges

Details

Type

Article

Created At

22 Jan 2023