Abstract
Eosinophilic gastroenteritis [EGE] is a rare disease characterized by peripheral eosinophilia and eosinophilic infiltration of the gastrointestional tract especially in stomach and proximal portion of small bowel it has a nonspecific clinical symptom depending on the affected GI loyer including abdominal pain. nausea, vomiting, diarrhea, weight loss, ascites, and malabsorption. The diagnosis is made, based on imaging, laboratory results, clinical finding and good response following treatment with steroids. We present a case of 51-year-old women complaining of abdominal pain, distention and loss of appetite for 2 weeks. After ruling out infection, liver pathology and malignancies by labs, colonoscop, diagnostic paracentesisis and CT, EGE was suspected Esophagogastroduodenoscopy was preformed, and duodenal biopsy showed infiltration of eosinophilis 8 cell HPF in the lamina propria. These findings confirmed a diagnosis of subserosal EGE. She was treated with prednisone [40 mg/d] with rapid improvement of her symptoms, normalization of the eosinophil count and disappearance of the abdominal fluid. Eosinophilic gastroenteritis is a rare disease and it should be kept in mind in patients of unexplained ascites. In such patients with negative workup, especially for parasitic infection and matignancy, EGE should be ruled out Although peripheral blood or ascitic fluid eosinophilia is suggestive, its absence does not exclude the possibility of this diagnosis. Diagnosis and treatment is imperative to avoid possible complications of the disease such malabsorption and malnutrition. Patients with high index of suspicion of EGE should receive treatment with steroids; dramatic response to treatment willl indirectly confirm the diagnosis of eosinophilic gastroenteritis and eosinophilic ascites.