Eosinophilic colitis / proctitis

Colon

Noninfectious colitis

Author: Hanni Gulwani, M.B.B.S.

Topic Completed: 1 May 2013

Minor changes: 11 December 2020

Copyright: 2003-2021, PathologyOutlines.com, Inc.

PubMed Search: eosinophilic colitis[title]

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Table of Contents

Cite 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)

Clinical images

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