Eosinophilic gastroenteritis with refractory ulcer disease and gastrointestinal bleeding as a rare manifestation of seronegative gastrointestinal food allergy

dc.contributor.authorRaithel, Martin
dc.contributor.authorHahn, Markus
dc.contributor.authorDonhuijsen, Konrad
dc.contributor.authorHagel, Alexander F.
dc.contributor.authorNägel, Andreas
dc.contributor.authorRieker, Ralf J.
dc.contributor.authorNeurath, Markus F.
dc.contributor.authorReinshagen, Max
dc.date.accessioned2014-12-19
dc.date.available2023-10-09T23:25:28Z
dc.date.created2014
dc.date.issued2014-12-19
dc.description.abstractGastrointestinal bleeding and iron deficiency anaemia may cause severe symptoms and may require extensive diagnostics and substantial amounts of health resources. This case report focuses on the clinical presentation of a 22 year old patient with recurrent gastrointestinal bleeding from multilocular non-healing ulcers of the stomach, duodenum and jejunum over a period of four years. Extensive gastroenterological and allergological standard diagnostic procedures showed benign ulcerative lesions with tissue eosinophilia, but no conclusive diagnosis. Multiple diagnostic procedures were performed, until finally, endoscopically guided segmental gut lavage identified locally produced, intestinal IgE antibodies by fluoro-enzyme-immunoassay. IgE antibody concentrations at the intestinal level were found to be more-fold increased for total IgE and food-specific IgE against nuts, rye flour, wheat flour, pork, beef and egg yolk compared with healthy controls. Thus, a diet eliminating these allergens was introduced along with antihistamines and administration of a hypoallergenic formula, which resulted in complete healing of the multilocular ulcers with resolution of gastrointestinal bleeding. All gastrointestinal lesions disappeared and total serum IgE levels dropped to normal within 9 months. The patient has been in remission now for more than two years. Eosinophilic gastroenteritis (EG) is well known to induce refractory ulcer disease. In this case, the mechanisms for intestinal damage and gastrointestinal bleeding were identified as local gastrointestinal type I allergy. Therefore, future diagnostics in EG should also be focused on the intestinal level as identification of causative food-specific IgE antibodies proved to be effective to induce remission in this patient.en
dc.format.extentS. 93 - 101
dc.identifier.citationNutrition Journal 13 (2014): S. 93 - 102. <http://www.nutritionj.com/content/13/1/93>
dc.identifier.opus-id5610
dc.identifier.urihttps://open.fau.de/handle/openfau/5610
dc.identifier.urnurn:nbn:de:bvb:29-opus4-56101
dc.language.isoen
dc.rights.urihttp://www.gesetze-im-internet.de/urhg/index.html
dc.subjectEosinophilic gastroenteritis (EG)
dc.subjectGastrointestinally mediated allergy (GMA)
dc.subjectRefractory ulcer disease
dc.subjectGastrointestinal bleeding
dc.subjectSeronegative food allergy
dc.subject.ddcDDC Classification::6 Technik, Medizin, angewandte Wissenschaften :: 61 Medizin und Gesundheit :: 610 Medizin und Gesundheit
dc.titleEosinophilic gastroenteritis with refractory ulcer disease and gastrointestinal bleeding as a rare manifestation of seronegative gastrointestinal food allergyen
dc.typearticle
dcterms.publisherFriedrich-Alexander-Universität Erlangen-Nürnberg (FAU)
local.journal.titleNutrition Journal
local.journal.volume13
local.sendToDnbfree*
local.subject.fakultaetMedizinische Fakultät
local.subject.gnd-
local.subject.sammlungUniversität Erlangen-Nürnberg / Von der FAU geförderte Open Access Artikel / Von der FAU geförderte Open Access Artikel 2014
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