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eosinophilic gastritis

Tuesday 14 December 2004

gastric eosinophilic inflammation; gastric eosinophilic infiltration; gastric eosinophilia

Definition: Excessive infiltration by eosinophilic leukocytes.

Pathology

Eosinophilic gastritis is a rare condition that is thought to be one manifestation of a generalized involvement of the alimentary tract by an allergic reaction, eosinophilic gastroenteritis. The diagnosis should be made with caution.

It is not sufficient to see conspicuous numbers of eosinophils; eosinophils must be the dominant cell type with little or no increase in other inflammatory cell types.

A marked increase in eosinophils, usually focal, can be seen in some cases of Crohn disease and parasitic diseases and accompanying some peptic ulcers and carcinomas.

Eosinophilic gastritis can be diagnosed with greater confidence when there is a history of allergic disease, such as asthma, food intolerance, and atopic eczema (70% of cases), and there is a peripheral blood eosinophilia (60,84).

The stomach is the most common site of involvement and eosinophilic infiltration is maximal in the antrum, but the esophagus and small intestine are also frequently involved.

Some observers consider the presence of any eosinophils in gastric mucosa to be abnormal, but most believe that a few eosinophils may be present in the normal lamina propria.

On the other hand, intraepithelial eosinophils, which usually occur in the context of generalized mucosal eosinophilia, are always viewed as abnormal.

Eosinophilic gastritis can be a manifestation of a generalized involvement of the alimentary tract by an allergic reaction, eosinophilic gastroenteritis. The diagnosis should be made with caution.

It is not sufficient to see conspicuous numbers of eosinophils; eosinophils must be the dominant cell type with little or no increase in other inflammatory cell types.

A marked increase in eosinophils, usually focal, can be seen in some cases of Crohn disease and parasitic diseases and accompanying some peptic ulcers and carcinomas.

Eosinophilic gastritis can be diagnosed with greater confidence when there is a history of allergic disease, such as asthma, food intolerance, and atopic eczema (70% of cases), and there is a peripheral blood eosinophilia (60,84).

The stomach is the most common site of involvement and eosinophilic infiltration is maximal in the antrum, but the esophagus and small intestine are also frequently involved.

Synopsis

- eosinophilic infiltrate of the gastric chorion
- eosinophils in gastric surface epithelium and gastric glandular epithelium

Etiology

- isolated eosinophilic gastritis
- associated eosinophilic gastritis

  • eosinophilic gastrointestinal disorders
  • eosinophilic gastroenteritis

- allergic reactions (allergic gastritis)
- peptic ulcers
- drug reactions
- gastric Crohn disease (Crohn gastritis)
- parasite reactions
- foreign bodies
- allergic granulomatosis
- gastric adenomas
- chronic granulomatous disease
- gastric carcinomas
- Langerhans cell histiocytosis
- varioliform gastritis
- gastric T-cell lymphoma
- inflammatory fibroid polyp
- eosinophilic gastroenteritis

See also

- Gastritis

  • chronic gastritis

- eosinophilic inflammation
- eosinophilic disorders