CHRU de Montpellier, Hôpital Saint-Eloi, Service d’Hépato- Gastro-entérologie B, 34000 Montpellier
CHRU de Clermont-Ferrand, Hôpital Estaing, Service de Médecine Digestive, 63000 Clermont-Ferrand
Clinique du Parc, 34170 Castelnau-le-Lez
Eosinophilic gastroenteritis is an uncommon disease of the digestive tract, probably underdiagnosed, due to the infiltration of the different intestinal layers by polymorphonuclear eosinophilic cells. It brings together esophageal, gastric, enteric and colic attacks. Isolated infiltration of the esophagus is considered as an independent disease called eosinophilic esophagitis. Personal or familial atopy is found in less than half of the patients. Its origin is currently unknown. The clinical history, very variable and nonspecific, will depend on the intestinal layer affected, whether it involves either the mucosa, the muscularis or the serosa. The affected digestive segment will also have an impact on the symptomatology. The diagnosis is complex, requiring digestive clinical signs or symptoms associated with histologically proved eosinophilic pathologic infiltration and the elimination of other causes of digestive hypereosinophilia, particularly parasitic infestation. The diagnostic strategy is therefore centered on endoscopic explorations. The course is variable, generally benign, which can range from an isolated flare to continuous active disease. Systemic or topical corticosteroid therapy remains the first-line treatment in the acute phase. The disease-modifying treatment is based on the elimination of food allergens and gradual reintroduction.
In refractory or recurrent forms, antihistamines, immunosuppressants or new biologic treatments could be used.