Table of Contents
Definition / general | Clinical features | Case reports | Treatment | Clinical images | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Gulwani H. Eosinophilic colitis / proctitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/coloneosinophilic.html. Accessed March 4th, 2021.
Definition / general
- Primary eosinophilic colitis may be related to altered hypersensitivity, principally as a food allergy in infants and T lymphocyte mediated (i.e. non-IgE associated) in young adults (Therap Adv Gastroenterol 2011;4:301), see also Allergic colitis
- Other causes include eosinophilic gastroenteritis (peripheral eosinophilia, allergic history), allergic proctitis in adults (resembles ulcerative colitis), Anasakis (Am J Surg Pathol 2003;27:1167), Strongyloides (Ital J Gastroenterol Hepatol 1999;31:607) or other parasites, clozapine use (Ann Clin Psychiatry 1995;7:97) and carbamazepine (Epilepsia 1992;33:119)
Clinical features
- In infants, is frequently food related; resolves in days after dietary changes
- In adults, symptoms include diarrhea, abdominal pain, weight loss
- Intestinal involvement is primarily mucosal, presenting as a mild self limited proctitis in infants and self limited colitis in young adults (Br Med Bull 2011;100:59)
Case reports
- 24 year old woman with eosinophilic gastroenteritis presenting with severe anemia (J Am Board Fam Med 2012;25:913)
- 29 year old woman with eosinophilic colitis post bone marrow transplant for AML (Int J Hematol 2003;78:76)
- 32 year old woman with ascites (Saudi Med J 2005;26:1983)
- 32 year old woman with Enterobius vermicularis (Ned Tijdschr Geneeskd 2003;147:813)
- 45 year old man with toxic hemorrhagic colitis (Case Rep Gastrointest Med 2012;2012:279813)
- 46 year old woman with severe bloody diarrhea (Turk J Gastroenterol 2008;19:54)
- 52 year old man with idiopathic hypereosinophilic syndrome (Eur J Gastroenterol Hepatol 2008;20:574)
- 56 year old man with hypereosinophilic syndrome (Clin Endosc 2012;45:444)
- 78 year old woman with crystal storing histiocytosis (Am J Surg Pathol 2007;31:481)
Treatment
- Elimination diets to avoid a presumed allergen
- Antihistamines or leukotriene receptor antagonists (Br Med Bull 2011;100:59)
- Adolescent or older patients require aggressive medical management including glucocorticoids, antihistamines, leukotriene receptors antagonists as well as novel approaches with drugs targeting IL5 and IgE (Therap Adv Gastroenterol 2011;4:301, World J Gastroenterol 2009;15:2975)
Microscopic (histologic) description
- Markedly increased mucosal eosinophilia (Adv Anat Pathol 2011;18:335)
Microscopic (histologic) images
Differential diagnosis