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Difference between revisions of "Eosinophilic colitis"
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'''Eosinophilic colitis''', abbreviated '''EC''', is an inflammatory process involving the [[colon]] ([[colitis]]) characterized by abundant [[eosinophil]]s. | |||
==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/> | |||
DDx:<ref name=pmid22012125/> | |||
*[[Inflammatory bowel disease]]: | |||
**[[Crohn's disease]]. | |||
**[[Ulcerative colitis]]. | |||
*Infection: | |||
**[[Pinworm]]. | |||
**[[Strongyloidiasis]]. | |||
*Autoimmune disease: | |||
**[[Scleroderma]]. | |||
**[[Churg-Strauss syndrome]]. | |||
**[[Celiac disease]]. | |||
*[[Drug reaction]]s. | |||
Image: | |||
*[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> | |||
==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]] | |||