Abstract:

Objective To improve the recognition of eosinophilic gastroenteritis（EG） in children. Methods The data of clinical manifestation, imageological examination, diagnosis and management from a 14-year-old boy with eosinophilic gastroenteritis presenting as acute pancreatitis were retrospectively analyzed. Clinical features of similar cases from published literatures were summarized.And related literatures were also reviewed systematically. Results A 14-year-old boy was admitted to our hospital due to abdominal pain and diarrhea for 1 week.He was early diagnosed as acute pancreatitis.Test results showed significant increase of eosinophils proportion (62%)，serum IgE (393 U·mL-1) and proportion of eosinophils in bone marrow cytology. Esophagogastroduodenoscopy indicated eosinophilic infiltration in duodenum. Furtherly，he was confirmed eosinophilic gastroenteritis by duodenal mucosa biopsy which showed eosinophilic infiltration. After the therapy of prednisone and anti-allergic drugs,he had complete remission 1 week later.And the peripheral eosinophils proportion was decreased to normal. And the boy didn’t have a relapse more than two years. The Wanfang digital knowledge service platform，CNKI, Elsevier, and PubMed were searched for relevant articles. 11 studies were included and 14 cases were summarized. All patients were misdiagnosed due to the initial performance of acute pancreatitis. All patients had nonspecific clinical manifestations such as abdominal pain, nausea and vomiting,but with peripheral blood EOS significantly increased.The proportion of EOS in ascites had important significance to the diagnosis of EG complicated with acute pancreatitis.All patients had different degrees of abnormal changes of stomach and duodenum mucosa.13 patients receiving glucocorticoid treatment after diagnosis had good prognosis. One case replased after surgical removal of the pancreas, and treating with glucocorticoid after diagnosis had good prognosis. Conclusion Children with EG complicated with acute pancreatitis are rare. Acute pancreatitis with unknown causes and accompanied with eosinophilia or bad clinical outcome after conventional treatment of enzyme or acid inhibition may indicate the possibility of eosinophilic gastroenteritis. Endoscope pathology biopsy should be taken as early as possible to confirm the diagnosis.