Eosinophilic colitis: Difference between revisions
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Eosinophilic_colitis_-_alt_--_high_mag.jpg | |||
| Width = | |||
| Caption = Eosinophilic colitis. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = abundant eosinophils - no agreed upon number - "most use 20/HPF", there is variation along the large bowel - normal in rectum <10/HPF, normal in cecum <30/HPF | |||
| Subtypes = | |||
| LMDDx = | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[colon]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = | |||
| Bloodwork = +/-eosinophilia | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = | |||
| Tx = dependent on underlying cause | |||
}} | |||
'''Eosinophilic colitis''', abbreviated '''EC''', is an inflammatory process involving the [[colon]] ([[colitis]]) characterized by abundant [[eosinophil]]s. | |||
'''Eosinophilic proctitis''' redirects to this article, as the histology is quite similar. | |||
==General== | |||
*Rare. | |||
*May be a component of ''[[eosinophilic gastroenteritis]]''.<ref name=pmid22012125/> | |||
Clinical features:<ref name=pmid22012125/> | |||
*Abdominal pain | |||
*Diarrhea +/-blood. | |||
*+/-Weight loss. | |||
==Gross== | |||
Features - endoscopic:<ref name=pmid22012125>{{Cite journal | last1 = Alfadda | first1 = AA. | last2 = Storr | first2 = MA. | last3 = Shaffer | first3 = EA. | title = Eosinophilic colitis: an update on pathophysiology and treatment. | journal = Br Med Bull | volume = 100 | issue = | pages = 59-72 | month = | year = 2011 | doi = 10.1093/bmb/ldr045 | PMID = 22012125 | PMC = 3165205 }}</ref> | |||
*Edema. | |||
*Granular appearance. | |||
==Microscopic== | |||
Features:<ref name=pmid22012125/> | |||
*Abundant eosinophils - no agreed upon number. | |||
**"Most use 20/[[HPF]]" <ref name=pmid19554649>{{Cite journal | last1 = Okpara | first1 = N. | last2 = Aswad | first2 = B. | last3 = Baffy | first3 = G. | title = Eosinophilic colitis. | journal = World J Gastroenterol | volume = 15 | issue = 24 | pages = 2975-9 | month = Jun | year = 2009 | doi = | PMID = 19554649 | PMC = 2702104 }}</ref> - a definition that suffers from [[HPFitis]]. | |||
***There is variation along the large bowel - normal in rectum <10/HPF, normal in cecum <30/HPF.<ref name=pmid19554649/> | |||
*+/-Eosinophilic crytitis.<ref name=pmid24278727>{{Cite journal | last1 = Bates | first1 = AW. | title = Diagnosing eosinophilic colitis: histopathological pattern or nosological entity? | journal = Scientifica (Cairo) | volume = 2012 | issue = | pages = 682576 | month = | year = 2012 | doi = 10.6064/2012/682576 | PMID = 24278727 }}</ref> | |||
DDx:<ref name=pmid22012125/> | |||
*[[Inflammatory bowel disease]]: | |||
**[[Crohn's disease]]. | |||
**[[Ulcerative colitis]]. | |||
*Infection: | |||
**[[Pinworm]]. | |||
**[[Strongyloidiasis]]. | |||
*Autoimmune disease: | |||
**[[Scleroderma]]. | |||
**[[Eosinophilic granulomatosis with polyangiitis]] (Churg-Strauss syndrome). | |||
**[[Celiac disease]]. | |||
*[[Drug reaction]]s. | |||
===Images=== | |||
www: | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702104/figure/F1/ EC (nih.gov)].<ref name=pmid19554649>{{Cite journal | last1 = Okpara | first1 = N. | last2 = Aswad | first2 = B. | last3 = Baffy | first3 = G. | title = Eosinophilic colitis. | journal = World J Gastroenterol | volume = 15 | issue = 24 | pages = 2975-9 | month = Jun | year = 2009 | doi = | PMID = 19554649 | PMC = 2702104 }}</ref> | |||
<gallery> | |||
Image: Eosinophilic colitis -- intermed mag.jpg | EC - intermed. mag. (WC) | |||
Image: Eosinophilic colitis -- high mag.jpg | EC - high mag. (WC) | |||
Image: Eosinophilic colitis - alt -- high mag.jpg | EC - high mag. (WC) | |||
Image: Eosinophilic colitis -- very high mag.jpg | EC - very high mag. (WC) | |||
Image: Eosinophilic colitis - alt -- very high mag.jpg | EC - very high mag. (WC) | |||
</gallery> | |||
==Sign out== | |||
<pre> | |||
DESCENDING COLON, BIOPSY: | |||
- COLONIC MUCOSA WITH MILD EOSINOPHILIA, SEE COMMENT. | |||
- NEGATIVE FOR DYSPLASIA. | |||
COMMENT: | |||
Focally, there are up to 40 eosinophils / 0.2376 mm*mm (approx. field area at 400X). This | |||
is a non-specific finding. No eosinophilic crypt abscesses are seen. No (neutrophilic) | |||
cryptitis is present. Clinical correlation is suggested. | |||
</pre> | |||
<pre> | |||
DESCENDING COLON, BIOPSY: | |||
- COLONIC MUCOSA WITH MILD EOSINOPHILIA, SEE COMMENT. | |||
- NEGATIVE FOR ACTIVE COLITIS. | |||
- NEGATIVE FOR DYSPLASIA. | |||
COMMENT: | |||
There are up to 40 eosinophils / 0.2376 mm*mm (field area at 400X). This is a | |||
non-specific finding. The differential diagnosis includes inflammatory bowel | |||
disease, infection (especially helminths), a drug reaction, and autoimmune | |||
disorders (e.g. Churg-Strauss syndrome, celiac disease, scleroderma). Clinical | |||
correlation is required. | |||
</pre> | |||
==See also== | |||
*[[Colon]]. | |||
*[[Eosinophilic esophagitis]]. | |||
*[[Eosinophilic gastritis]]. | |||
*[[Eosinophil]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Colon]] | |||