Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2022; 10(19): 6417-6427
Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6417
Preliminary evidence in treatment of eosinophilic gastroenteritis in children: A case series
Ying Chen, Mei Sun
Ying Chen, Mei Sun, Department of Pediatric Gastroenterology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Chen Y and Sun M were gastroenterologists, conceptualized the study, reviewed the literature of eosinophilic gastroenteritis, and drafted the manuscript; Chen Y searched the computerized database of our hospital, collected the patients’ data, and analyzed the data; and all authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Institutional Review Board of ShengJing Hospital of China Medical University (No. 2020PS806K).
Informed consent statement: The requirement for written informed consent was waived by the Institutional Review Board due to the respective nature of this study. All procedures performed in the present study were in accordance with Declaration of Helsinki.
Conflict-of-interest statement: The authors declare that there is no conflict of interest to disclose.
Data sharing statement: The data used and analyzed in this study are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mei Sun, MD, Chief Doctor, Department of Pediatric Gastroenterology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, Liaoning Province, China. sunmei_shenyang@163.com
Received: August 13, 2021
Peer-review started: August 13, 2021
First decision: November 11, 2021
Revised: November 23, 2021
Accepted: April 21, 2022
Article in press: April 21, 2022
Published online: July 6, 2022
Processing time: 314 Days and 23.8 Hours
Abstract
BACKGROUND

Eosinophilic gastroenteritis is a rare inflammatory disorder in children. However, there is still no standard guideline in the treatment of pediatric eosinophilic gastroenteritis.

AIM

To report our experience with the diagnosis and treatment of children with eosinophilic gastroenteritis.

METHODS

From January 2017 to December 2019, a total of 22 children were diagnosed with eosinophilic gastroenteritis.

RESULTS

Endoscopic examination showed eosinophil infiltration in the duodenum [mean number of eosinophils/high-power field (HPF) = 53.1 ± 81.5], stomach (mean number of eosinophils/HPF = 36.8 ± 50.5), and terminal ileum (mean number of eosinophils/HPF = 49.0 ± 24.0). All 18 children with low eosinophil infiltration (< 14%) responded well to the initial drug treatment without relapse, while two of four children with high eosinophil infiltration (> 14%) relapsed after initial methylprednisolone/montelukast treatment. In addition, children with high eosinophil infiltration (> 14%) showed symptomatic relief and histological remission without further relapse after receiving budesonide/methylprednisolone as initial or relapse treatment.

CONCLUSION

Methylprednisolone/montelukast is still the best treatment for children with low eosinophil infiltration (< 14%). Budesonide can be considered as the initial or relapse treatment for children with high eosinophil infiltration (> 14%).

Keywords: Eosinophil gastroenteritis; Children; Budesonide; Methylprednisolone; Montelukast; Absolute eosinophil count

Core Tip: Pediatric eosinophilic gastroenteritis is a rare inflammatory disorder, and there is still no standard treatment guideline. Based on our treatment experience and analysis, the level of eosinophil infiltration may be an important factor affecting the treatment outcome. Methylprednisolone/montelukast is still the best treatment for children with lower eosinophil percentage (< 14%). Budesonide can be considered as the initial or relapse treatment for children with high eosinophil infiltration (> 14%).