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
ARTICLE HIGHLIGHTS
Research background

Eosinophilic gastroenteritis is a rare inflammatory disorder in children. Children with eosinophilic gastritis may severely cause growth retardation, delayed puberty, and amenorrhea. The diagnosis of eosinophilic gastroenteritis generally includes the appearance of abnormal gastrointestinal symptoms, the presence of ≥ 20 eosinophils per high-power field (HPF), and exclusion of other secondary causes such as parasite or tuberculosis infection. However, there is still no validated guideline for the clinical management of children with eosinophilic gastroenteritis.

Research motivation

Although some studies recommend dietary restrictions and the use of corticosteroids as first-line treatment, our clinical practice shows some different diagnosis and treatment findings.

Research objectives

Considering the rarity of pediatric eosinophilic gastroenteritis in China and the limited understanding of its diagnosis and treatment, the objective of this study was to report our experience with the diagnosis and treatment of 22 children with eosinophilic gastroenteritis in China.

Research methods

A total of 22 children with histologically confirmed eosinophilic gastroenteritis were enrolled in the study. The diagnosis of eosinophilic gastroenteritis was based on Talley’s diagnostic criteria. Clinical data of the children including demographics, allergic histories, and laboratory and endoscopic examination were retrospectively reviewed and analyzed.

Research results

All children received dietary restrictions. First-line drug treatment included methylprednisolone, montelukast, budesonide, and lansoprazole. All children with low eosinophil percentage (< 14%) responded very well to first-line drug treatment without relapse. Half of children with high eosinophil infiltration (> 14%) and C-reactive protein (CRP) levels (> 1 mg/dL) relapsed after treatment with methylprednisolone and montelukast. However, budesonide is an effective first-line and relapse treatment for children with high eosinophil infiltration (> 14%) and CRP levels.

Research conclusions

Based on our clinical practice, we recommend corticosteroids as the first-line treatment for low eosinophil infiltration (< 14%). Budesonide is recommended as the first-line or relapse treatment for children with high eosinophil infiltration and CRP levels.

Research perspectives

Although our clinical practice showed the promising preliminary evidence of budesonide in the relapse treatment of children with high eosinophil infiltration, multicenter prospective or retrospective studies with a large sample size should be conducted to further validate the findings.