John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Eosinophilic colitis in adults Volume 25, issue 8, Octobre 2018

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Author
Centre Hospitalier Marne la Vallée (GHEF), Service d’hépato-gastro-entérologie, 2-4 cours de la Gondoire 77 600 Jossigny, France
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Eosinophilic colitis (EC) is a pathological entity associated with abnormal infiltration of colonic mucosa by eosinophilic polynuclear. This is a relatively common disease in infants and children less than two year-old, which is less common and less studied in adults. EC can be classified as primitive or secondary. The primary EC are, in the majority of cases, related to an allergic reaction, either IgE-mediated and at the origin of anaphylactic-type food allergy, or not mediated by IgE and at the origin of food enteropathy.

The symptoms of adults with EC is variable and nonspecific, diarrhoea and abdominal pain being the most common signs.

There is no histological consensus for the diagnosis of EC. A rate of eosinophilic polymorphonuclear cells over 40 per high-power field in at least two different colic segments could be the criterion for the diagnosis.

In adults with primary EC, skin tests have a reduced profitability and the response to restrictive diet is less effective than in young children, IgE or non-IgE-mediated allergic reactions being rarely identified and most often requiring medical treatment. There is no consensus for the treatment of EC; the potential efficacy of corticosteroids and budesonide has been demonstrated in the vast majority of cases.

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