Eosinophilic enteritis in a case of cystic fibrosis: an elusive diagnosis with an elementary cure.
Gomathy Aarthy NageswaranViveksandeep Thoguluva ChandrasekarIntisar GhleilibJohn Erikson YapPublished in: BMJ case reports (2023)
A late adolescent man diagnosed with cystic fibrosis and presenting with predominantly gastrointestinal symptoms, including chronic constipation, exocrine pancreatic insufficiency and gastro-oesophageal reflux disease, experienced recurrent episodes of nausea, vomiting and abdominal pain. CT of the abdomen unveiled the presence of chronic appendicitis, alongside constipation without evidence of distal intestinal obstruction syndrome. Endoscopic biopsies revealed small bowel eosinophilic infiltrates. Subsequently, the patient underwent an appendectomy, and a tailored regimen was established to address constipation, resulting in an initial alleviation of his symptoms. Three months later, a resurgence of symptoms occurred, coinciding with persistent intestinal eosinophilic infiltrates. A diagnosis of eosinophilic enteritis was rendered, and treatment commenced with an oral dosage of 40 mg of prednisone. Two weeks later, the patient experienced symptom resolution, corroborated by the findings of an endoscopic biopsy conducted 8 weeks later. During a follow-up examination 6 months later, the patient remained asymptomatic.
Keyphrases
- abdominal pain
- case report
- ultrasound guided
- cystic fibrosis
- chronic rhinosinusitis
- small bowel
- irritable bowel syndrome
- young adults
- pseudomonas aeruginosa
- mental health
- magnetic resonance imaging
- fine needle aspiration
- chronic obstructive pulmonary disease
- gestational age
- contrast enhanced
- single molecule
- image quality
- single cell
- preterm birth
- dual energy
- patient reported
- positron emission tomography