PDF(Pubmed)
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.
OBJECTIVE: 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.
CONCLUSIONS: 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%).
OBJECTIVE: 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.
CONCLUSIONS: 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%).
摘要：
背景：嗜酸性粒细胞性胃肠炎是一种罕见的儿童炎症性疾病。然而,目前尚无治疗小儿嗜酸性粒细胞性胃肠炎的标准指南.
目的：报告儿童嗜酸性粒细胞性胃肠炎的诊治经验。
方法：2017年1月至2019年12月，共22例患儿被诊断为嗜酸性粒细胞性胃肠炎。
结果：内镜检查显示十二指肠有嗜酸性粒细胞浸润[嗜酸性粒细胞平均数/高倍视野(HPF)=53.1±81.5]，胃（嗜酸性粒细胞/HPF的平均数量=36.8±50.5），和末端回肠（平均嗜酸性粒细胞数/HPF=49.0±24.0）。所有18例低嗜酸性粒细胞浸润（<14％）的儿童对初始药物治疗反应良好，无复发。而4例嗜酸性粒细胞高浸润(>14%)患儿中的2例在初次甲基强的松龙/孟鲁司特治疗后复发。此外,嗜酸性粒细胞高浸润(>14%)的儿童在接受布地奈德/甲基强的松龙作为初始或复发治疗后,症状缓解和组织学缓解,无进一步复发.
结论：甲基强的松龙/孟鲁司特仍然是低嗜酸性粒细胞浸润儿童的最佳治疗方法（<14%）。布地奈德可作为高嗜酸性粒细胞浸润(>14%)患儿的初始或复发治疗。
目的：报告儿童嗜酸性粒细胞性胃肠炎的诊治经验。
方法：2017年1月至2019年12月，共22例患儿被诊断为嗜酸性粒细胞性胃肠炎。
结果：内镜检查显示十二指肠有嗜酸性粒细胞浸润[嗜酸性粒细胞平均数/高倍视野(HPF)=53.1±81.5]，胃（嗜酸性粒细胞/HPF的平均数量=36.8±50.5），和末端回肠（平均嗜酸性粒细胞数/HPF=49.0±24.0）。所有18例低嗜酸性粒细胞浸润（<14％）的儿童对初始药物治疗反应良好，无复发。而4例嗜酸性粒细胞高浸润(>14%)患儿中的2例在初次甲基强的松龙/孟鲁司特治疗后复发。此外,嗜酸性粒细胞高浸润(>14%)的儿童在接受布地奈德/甲基强的松龙作为初始或复发治疗后,症状缓解和组织学缓解,无进一步复发.
结论：甲基强的松龙/孟鲁司特仍然是低嗜酸性粒细胞浸润儿童的最佳治疗方法（<14%）。布地奈德可作为高嗜酸性粒细胞浸润(>14%)患儿的初始或复发治疗。
