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Abstract：
BACKGROUND: Eosinophilic gastrointestinal disorders, also known as eosinophilic gastroenteritis, are rare inflammatory conditions characterized by eosinophilic infiltration of different parts of the gastrointestinal tract, along with peripheral eosinophilia in most cases. Other known causes for gut eosinophilic infiltration must be excluded to confirm the diagnosis of eosinophilic gastroenteritis. Symptoms of the disorder depend on the affected gastrointestinal tract segment and depth of involvement. Treatment includes systemic glucocorticoids and/or dietary therapy with an empiric elimination diet. Second line therapies include the leukotriene receptor antagonist montelukast, and other anti-allergy drugs such as mast cell stabilizers (including cromolyn and the H1-antihistamine ketotifen), suplatast tosilate which is a selective Th-2 cytokines (IL-4 and IL-5) inhibitor, and the monoclonal anti-IgE antibody omalizumab. We report a case of eosinophilic gastroenteritis who was successfully treated and achieved remission with montelukast as an initial monotherapy. Upon extensive literature review, this represents the second reported adult case of eosinophilic gastroenteritis who responds to montelukast alone as a first line therapy.
METHODS: A 49-year-old female presented with recurrent abdominal pain, vomiting, diarrhea and unexplained eosinophilia. She was diagnosed with eosinophilic gastroenteritis and was successfully treated with montelukast monotherapy. After 7 days of therapy, the patient responded well and had complete resolution of her gastrointestinal symptoms and peripheral eosinophilia. Patient remained in remission on follow-up after 12 months. We reviewed the literature for leukotriene antagonist use in the treatment of eosinophilic gastroenteritis and included the cases treated with the leukotriene antagonist montelukast as an initial therapy or as a second line therapy for refractory disease.
CONCLUSIONS: Montelukast may be an effective treatment for eosinophilic gastroenteritis, either alone or in combination with systemic steroids or ketotifen. Our patient is the second reported adult case of eosinophilic gastroenteritis who responded to montelukast alone as a first line therapy. Further studies and clinical trials are required to confirm efficacy compared to standard therapy.
METHODS: A 49-year-old female presented with recurrent abdominal pain, vomiting, diarrhea and unexplained eosinophilia. She was diagnosed with eosinophilic gastroenteritis and was successfully treated with montelukast monotherapy. After 7 days of therapy, the patient responded well and had complete resolution of her gastrointestinal symptoms and peripheral eosinophilia. Patient remained in remission on follow-up after 12 months. We reviewed the literature for leukotriene antagonist use in the treatment of eosinophilic gastroenteritis and included the cases treated with the leukotriene antagonist montelukast as an initial therapy or as a second line therapy for refractory disease.
CONCLUSIONS: Montelukast may be an effective treatment for eosinophilic gastroenteritis, either alone or in combination with systemic steroids or ketotifen. Our patient is the second reported adult case of eosinophilic gastroenteritis who responded to montelukast alone as a first line therapy. Further studies and clinical trials are required to confirm efficacy compared to standard therapy.
摘要：
背景：嗜酸性胃肠道疾病，也被称为嗜酸性粒细胞性胃肠炎，是罕见的炎症，其特征是胃肠道不同部位的嗜酸性粒细胞浸润，在大多数情况下，伴有外周嗜酸性粒细胞增多。必须排除肠道嗜酸性粒细胞浸润的其他已知原因，以确认嗜酸性粒细胞性胃肠炎的诊断。该疾病的症状取决于受影响的胃肠道段和受累深度。治疗包括全身性糖皮质激素和/或经验性消除饮食的饮食疗法。二线治疗包括白三烯受体拮抗剂孟鲁司特，和其他抗过敏药物，如肥大细胞稳定剂（包括色甘酸和H1-抗组胺酮替芬），甲磺酸是一种选择性Th-2细胞因子（IL-4和IL-5）抑制剂，和单克隆抗IgE抗体奥马珠单抗。我们报告了一例嗜酸性粒细胞性胃肠炎，该患者成功治疗并以孟鲁司特作为初始单一疗法获得缓解。经过广泛的文献回顾，这是第二例报道的成人嗜酸性粒细胞性胃肠炎病例,单用孟鲁司特作为一线治疗有疗效.
方法：一名49岁女性出现复发性腹痛，呕吐,腹泻和无法解释的嗜酸性粒细胞增多。她被诊断为嗜酸性粒细胞性胃肠炎，并成功接受孟鲁司特单药治疗。治疗7天后，患者反应良好,胃肠道症状和外周嗜酸性粒细胞增多已完全缓解.12个月后随访患者仍处于缓解状态。我们回顾了白三烯拮抗剂用于治疗嗜酸性粒细胞性胃肠炎的文献，并包括了用白三烯拮抗剂孟鲁司特作为难治性疾病的初始治疗或二线治疗的病例。
结论：孟鲁司特可能是治疗嗜酸细胞性胃肠炎的有效方法。单独或与全身性类固醇或酮替芬联合使用。我们的患者是第二例报道的嗜酸性粒细胞性胃肠炎的成人病例，该病例仅对孟鲁司特作为一线治疗有反应。与标准疗法相比，需要进一步的研究和临床试验来确认疗效。
方法：一名49岁女性出现复发性腹痛，呕吐,腹泻和无法解释的嗜酸性粒细胞增多。她被诊断为嗜酸性粒细胞性胃肠炎，并成功接受孟鲁司特单药治疗。治疗7天后，患者反应良好,胃肠道症状和外周嗜酸性粒细胞增多已完全缓解.12个月后随访患者仍处于缓解状态。我们回顾了白三烯拮抗剂用于治疗嗜酸性粒细胞性胃肠炎的文献，并包括了用白三烯拮抗剂孟鲁司特作为难治性疾病的初始治疗或二线治疗的病例。
结论：孟鲁司特可能是治疗嗜酸细胞性胃肠炎的有效方法。单独或与全身性类固醇或酮替芬联合使用。我们的患者是第二例报道的嗜酸性粒细胞性胃肠炎的成人病例，该病例仅对孟鲁司特作为一线治疗有反应。与标准疗法相比，需要进一步的研究和临床试验来确认疗效。
