Difference between revisions of "Eosinophilic colitis"

From Libre Pathology
Jump to navigation Jump to search
m
Line 1: Line 1:
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      =
| Width      =
| Caption    =
| 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 colitis''', abbreviated '''EC''', is an inflammatory process involving the [[colon]] ([[colitis]]) characterized by abundant [[eosinophil]]s.



Revision as of 12:28, 16 January 2014

Eosinophilic colitis
Diagnosis in short

LM 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
Site colon

Blood work +/-eosinophilia
Treatment dependent on underlying cause

Eosinophilic colitis, abbreviated EC, is an inflammatory process involving the colon (colitis) characterized by abundant eosinophils.

General

Clinical features:[1]

  • Abdominal pain
  • Diarrhea +/-blood.
  • +/-Weight loss.

Gross

Features - endoscopic:[1]

  • Edema.
  • Granular appearance.

Microscopic

Features:[1]

  • Abundant eosinophils - no agreed upon number.
    • "Most use 20/HPF" [2] - a definition that suffers from HPFitis.
      • There is variation along the large bowel - normal in rectum <10/HPF, normal in cecum <30/HPF.[2]

DDx:[1]

Image:

Sign out

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.
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.

See also

References

  1. 1.0 1.1 1.2 1.3 1.4 Alfadda, AA.; Storr, MA.; Shaffer, EA. (2011). "Eosinophilic colitis: an update on pathophysiology and treatment.". Br Med Bull 100: 59-72. doi:10.1093/bmb/ldr045. PMC 3165205. PMID 22012125. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165205/.
  2. 2.0 2.1 2.2 Okpara, N.; Aswad, B.; Baffy, G. (Jun 2009). "Eosinophilic colitis.". World J Gastroenterol 15 (24): 2975-9. PMC 2702104. PMID 19554649. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702104/. Cite error: Invalid <ref> tag; name "pmid19554649" defined multiple times with different content