Eosinophilic gastritis and gluten-sensitive enteropathy manifested as hypoproteinemia and treated with omalizumab: a case report
Abstract Background Eosinophilic gastritis (EoG) has rarely been reported in conjunction with gluten-sensitive enteropathy (GSE). When this does occur, patients typically present with gastrointestinal symptoms. To our knowledge, hypoproteinemia has not been reported as the primary manifestation. Ant...
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| Language: | English |
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BMC
2024-03-01
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| Series: | Allergy, Asthma & Clinical Immunology |
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| Online Access: | https://doi.org/10.1186/s13223-024-00878-8 |
| _version_ | 1797274259989463040 |
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| author | Zhirong Du Zixi Wang Weixun Zhou Jia Yin Yuxiang Zhi |
| author_facet | Zhirong Du Zixi Wang Weixun Zhou Jia Yin Yuxiang Zhi |
| author_sort | Zhirong Du |
| collection | DOAJ |
| description | Abstract Background Eosinophilic gastritis (EoG) has rarely been reported in conjunction with gluten-sensitive enteropathy (GSE). When this does occur, patients typically present with gastrointestinal symptoms. To our knowledge, hypoproteinemia has not been reported as the primary manifestation. Anti-IgE therapy, such as omalizumab, lowers eosinophil counts in the blood, lungs, and gut. Its efficiency in treating active EoG remain unknown. Case presentation We report a 33-month-old boy with a history of food allergy and atopic dermatitis who developed recurrent edema, hypoproteinemia, and eosinophilia at the age of 14 months. The diagnoses of EoG and GSE were confirmed based on the clinical presentation and results of gastrointestinal biopsies and serological testing. Although prednisone and dietary intervention were initially effective, the boy developed prednisone-related facial swelling. After stopping prednisone, his symptoms relapsed. Subsequent treatment with omalizumab, combined with dietary intervention, showed good efficacy and safety. Conclusions To our knowledge, this is the first case of concurrent EoG and GSE that presented primarily with hypoproteinemia. We highlight the rare manifestations of these two diseases to raise clinical suspicion and prevent missed and delayed diagnoses. The pathogenesis of EoG is heterogeneous and complex. Omalizumab showed good efficacy, indicating that IgE-mediated processes may be involved in the pathogenesis of this patient’s diseases. |
| first_indexed | 2024-03-07T14:56:49Z |
| format | Article |
| id | doaj.art-c8cf29659b934d4e9004ba119e0f8beb |
| institution | Directory Open Access Journal |
| issn | 1710-1492 |
| language | English |
| last_indexed | 2024-03-07T14:56:49Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Allergy, Asthma & Clinical Immunology |
| spelling | doaj.art-c8cf29659b934d4e9004ba119e0f8beb2024-03-05T19:25:10ZengBMCAllergy, Asthma & Clinical Immunology1710-14922024-03-012011610.1186/s13223-024-00878-8Eosinophilic gastritis and gluten-sensitive enteropathy manifested as hypoproteinemia and treated with omalizumab: a case reportZhirong Du0Zixi Wang1Weixun Zhou2Jia Yin3Yuxiang Zhi4Department of Allergy, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College HospitalDepartment of Allergy, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College HospitalDepartment of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Allergy, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College HospitalDepartment of Allergy, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College HospitalAbstract Background Eosinophilic gastritis (EoG) has rarely been reported in conjunction with gluten-sensitive enteropathy (GSE). When this does occur, patients typically present with gastrointestinal symptoms. To our knowledge, hypoproteinemia has not been reported as the primary manifestation. Anti-IgE therapy, such as omalizumab, lowers eosinophil counts in the blood, lungs, and gut. Its efficiency in treating active EoG remain unknown. Case presentation We report a 33-month-old boy with a history of food allergy and atopic dermatitis who developed recurrent edema, hypoproteinemia, and eosinophilia at the age of 14 months. The diagnoses of EoG and GSE were confirmed based on the clinical presentation and results of gastrointestinal biopsies and serological testing. Although prednisone and dietary intervention were initially effective, the boy developed prednisone-related facial swelling. After stopping prednisone, his symptoms relapsed. Subsequent treatment with omalizumab, combined with dietary intervention, showed good efficacy and safety. Conclusions To our knowledge, this is the first case of concurrent EoG and GSE that presented primarily with hypoproteinemia. We highlight the rare manifestations of these two diseases to raise clinical suspicion and prevent missed and delayed diagnoses. The pathogenesis of EoG is heterogeneous and complex. Omalizumab showed good efficacy, indicating that IgE-mediated processes may be involved in the pathogenesis of this patient’s diseases.https://doi.org/10.1186/s13223-024-00878-8Eosinophilic gastritisGluten-sensitive enteropathyHypoproteinemiaOmalizumab |
| spellingShingle | Zhirong Du Zixi Wang Weixun Zhou Jia Yin Yuxiang Zhi Eosinophilic gastritis and gluten-sensitive enteropathy manifested as hypoproteinemia and treated with omalizumab: a case report Allergy, Asthma & Clinical Immunology Eosinophilic gastritis Gluten-sensitive enteropathy Hypoproteinemia Omalizumab |
| title | Eosinophilic gastritis and gluten-sensitive enteropathy manifested as hypoproteinemia and treated with omalizumab: a case report |
| title_full | Eosinophilic gastritis and gluten-sensitive enteropathy manifested as hypoproteinemia and treated with omalizumab: a case report |
| title_fullStr | Eosinophilic gastritis and gluten-sensitive enteropathy manifested as hypoproteinemia and treated with omalizumab: a case report |
| title_full_unstemmed | Eosinophilic gastritis and gluten-sensitive enteropathy manifested as hypoproteinemia and treated with omalizumab: a case report |
| title_short | Eosinophilic gastritis and gluten-sensitive enteropathy manifested as hypoproteinemia and treated with omalizumab: a case report |
| title_sort | eosinophilic gastritis and gluten sensitive enteropathy manifested as hypoproteinemia and treated with omalizumab a case report |
| topic | Eosinophilic gastritis Gluten-sensitive enteropathy Hypoproteinemia Omalizumab |
| url | https://doi.org/10.1186/s13223-024-00878-8 |
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