Difference between revisions of "Eosinophilic colitis"

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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 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==
==General==
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**"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]].
**"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/>
***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/>
DDx:<ref name=pmid22012125/>
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*Autoimmune disease:
*Autoimmune disease:
**[[Scleroderma]].
**[[Scleroderma]].
**[[Churg-Strauss syndrome]].
**[[Eosinophilic granulomatosis with polyangiitis]] (Churg-Strauss syndrome).
**[[Celiac disease]].
**[[Celiac disease]].
*[[Drug reaction]]s.
*[[Drug reaction]]s.


Image:
===Images===
*[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>
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==
==Sign out==

Latest revision as of 21:47, 28 November 2016

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

Eosinophilic colitis
Diagnosis in short

Eosinophilic colitis. H&E stain.

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 proctitis redirects to this article, as the histology is quite similar.

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]
  • +/-Eosinophilic crytitis.[3]

DDx:[1]

Images

www:

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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/.
  3. Bates, AW. (2012). "Diagnosing eosinophilic colitis: histopathological pattern or nosological entity?". Scientifica (Cairo) 2012: 682576. doi:10.6064/2012/682576. PMID 24278727.