CHALLENGES IN THE CLINICAL DIAGNOSIS OF EOSINOPHILIC GASTROINTESTINAL CONDITIONS: CASE SERIES FROM TAM ANH HOSPITAL
Main Article Content
Abstract
Background and aims: Eosinophilic gastrointestinal diseases (EGIDs) are a rare group of disorders that have gained increasing attention in clinical practice. However, gastrointestinal tissue eosinophilia is nonspecific and may occur in various secondary conditions, while the lack of universally accepted diagnostic criteria continues to pose challenges in clinical evaluation. This study aimed to describe the clinical, endoscopic, and histopathological characteristics of patients with gastrointestinal eosinophilia in routine clinical practice.
Methods: We conducted a retrospective study of patients with predominant eosinophilic infiltration on gastrointestinal biopsies at Tam Anh General Hospital between December 2024 and April 2026. Histopathological inclusion criteria were based on site-specific eosinophil count thresholds. Clinical, endoscopic, laboratory, and histological data were collected and analyzed.
Results: A total of 40 patients were included, comprising 10 cases of eosinophilic esophagitis (EoE) and 30 cases of non-esophageal gastrointestinal eosinophilia. The most common presenting symptom was abdominal pain (57.5%). Peripheral eosinophilia was observed in 35.9% of patients. Positive parasite serology was identified in 40.7% of cases and was exclusively found in the non-esophageal group. Endoscopic findings were frequently nonspecific, with approximately 30% of patients showing normal endoscopic examinations. Eosinophilic colitis was the most common disease subtype (27.5%), followed by eosinophilic esophagitis (25.0%).
Conclusions: Clinical and endoscopic manifestations of gastrointestinal eosinophilia are generally nonspecific. The substantial proportion of patients with normal endoscopic findings despite abnormal histopathology highlights the pivotal role of biopsy. Our findings also underscore the need for a structured diagnostic approach in regions with a high prevalence of parasitic infections.
Keywords
Eosinophilic gastrointestinal disease, EGID, biopsy, endoscopy, eosinophilic esophagitis, parasitic infection
Article Details
References
2. Dellon Evan S., Gonsalves Nirmala, Abonia J. Pablo, et al. (2022) “International Consensus Recommendations for Eosinophilic Gastrointestinal Disease Nomenclature”. Clinical Gastroenterology and Hepatology.20(11):2474-84.e3.
3. Ketchem Corey J., Reed Craig C., Dellon Evan S. (2024) “The Natural History of Eosinophilic Gastrointestinal Diseases Is Influenced by Age of Onset and Location of Involvement”. American Journal of Gastroenterology.119(9):1813-20.
4. Kinoshita Yoshikazu, Sanuki Tsuyoshi. (2023) “Review of Non-Eosinophilic Esophagitis-Eosinophilic Gastrointestinal Disease (Non-EoE-EGID) and a Case Series of Twenty-Eight Affected Patients”. Biomolecules.13(9).
5. Marasco Giovanni, Visaggi Pierfrancesco, Vassallo Mariagiulia, et al. (2023) “Current and Novel Therapies for Eosinophilic Gastrointestinal Diseases”. International Journal of Molecular Sciences.24(20).
6. Migliorisi Giulia, Mastrorocco Elisabetta, Dal Buono Arianna, et al. (2024) “Eosinophils, Eosinophilic Gastrointestinal Diseases, and Inflammatory Bowel Disease: A Critical Review”. Journal of Clinical Medicine.13(14).
7. Visaggi Pierfrancesco, Dellon Evan S.( 2026) “Epidemiology, Natural History, and Treatment of Eosinophilic Gastrointestinal Diseases”. Gastroenterology.170(3):476-94.