Re: eosinophil - continued

[Guest guest]

Hi ;

From what I've read, eosinophils can accumulate in inflammed regions

of the gut in inflammatory bowel disease (they may be " attracted "

there by certain cytokines). I'm sorry, but I don't know enough

about what levels of eosinophils are considered to be " normal " in

IBD. However, researchers seem to have identified a distinct entity

called " eosinophilic gastroenteritis " which may be associated

with " prominent tissue eosinophilia " . Perhaps Suzanne's doctors

might be considering this, as it does often seem to be allergy

related?

________________________

Best Pract Res Clin Gastroenterol. 2005 Apr;19(2):177-98.

Eosinophilic gastroenteritis.

Khan S.

Division of Gastroenterology, University of Pittsburgh School of

Medicine, Children's Hospital of Pittsburgh, 3705 Fifth Avenue,

Pittsburgh, PA 15213, USA. seema.khan@...

Eosinophilic gastroenteritis despite its uncommon occurrence is one

of the most important primary eosinophilic gastrointestinal

disorders, and most commonly presents with abdominal pain. The

terminology is, however, misleading because all levels of the

gastrointestinal tract from the esophagus to the rectum may be

affected. A history of atopy and allergies is present in 25-75%

cases. The heterogeneity in the clinical presentations of EG is

determined by the site and depth of eosinophilic infiltration.

Eosinophilic intestinal inflammation also occurs secondarily in the

gastrointestinal tract in inflammatory bowel disease, autoimmune

diseases, as reactions to medications, infections, hypereosinophilia

syndrome, and after solid organ transplantation. Recent

investigations providing an insight into the pathogenesis of

eosinophilic gastroenteritis support a critical role for allergens,

eosinophils, Th-2 type cytokines, and eotaxin in mediating

eosinophilic inflammation. The diagnosis is confirmed by

demonstrating prominent tissue eosinophilia on histopathology.

Treatment recommendations based on data extrapolated from

retrospective, uncontrolled studies, and expert opinion support the

use of restricted diets, corticosteroids, leukotriene receptor

antagonists, and mast cell stabilizers. Many unanswered questions

remain with regard to the natural history, optimal duration of

therapy, safer steroid-sparing long-term treatment agents, and the

means of reliable and non-invasive follow-up.

Publication Types:

Review

PMID: 15833687

________________________

I wish you all the best with the allergist visit tomorrow.

Best regards,

Dave

(father of (20); PSC 07/03; UC 08/03)

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> ,

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> Suzanne's GI said there were eosinophil cells in her esophagus,

but at a level common in IBD; these were also present during her

initial scope (at dx). She then said the eosinophil cells in her

colon were significant, much more than could be explained by IBD.

Also, this was the first time they saw eosinophil cells in her

colon. I am not sure what the levels of " normal " elevation related

to IBD would be versus what significant levels of elevation would

look like that could not be explained by IBD. We see the allergist

tomorrow and if I remember I will ask more about this.