eosinophilic gastritis

Definition: Excessive infiltration by eosinophilic leukocytes.

Pathology

Eosinophilic gastritis is a rare condition that is thought to be one manifestation of a generalized involvement of the alimentary tract by an allergic reaction, eosinophilic gastroenteritis. The diagnosis should be made with caution.

It is not sufficient to see conspicuous numbers of eosinophils; eosinophils must be the dominant cell type with little or no increase in other inflammatory cell types.

A marked increase in eosinophils, usually focal, can be seen in some cases of Crohn disease and parasitic diseases and accompanying some peptic ulcers and carcinomas.

Eosinophilic gastritis can be diagnosed with greater confidence when there is a history of allergic disease, such as asthma, food intolerance, and atopic eczema (70% of cases), and there is a peripheral blood eosinophilia (60,84).

The stomach is the most common site of involvement and eosinophilic infiltration is maximal in the antrum, but the esophagus and small intestine are also frequently involved.

Some observers consider the presence of any eosinophils in gastric mucosa to be abnormal, but most believe that a few eosinophils may be present in the normal lamina propria.

On the other hand, intraepithelial eosinophils, which usually occur in the context of generalized mucosal eosinophilia, are always viewed as abnormal.

Eosinophilic gastritis can be a manifestation of a generalized involvement of the alimentary tract by an allergic reaction, eosinophilic gastroenteritis. The diagnosis should be made with caution.

It is not sufficient to see conspicuous numbers of eosinophils; eosinophils must be the dominant cell type with little or no increase in other inflammatory cell types.

A marked increase in eosinophils, usually focal, can be seen in some cases of Crohn disease and parasitic diseases and accompanying some peptic ulcers and carcinomas.

Eosinophilic gastritis can be diagnosed with greater confidence when there is a history of allergic disease, such as asthma, food intolerance, and atopic eczema (70% of cases), and there is a peripheral blood eosinophilia (60,84).

The stomach is the most common site of involvement and eosinophilic infiltration is maximal in the antrum, but the esophagus and small intestine are also frequently involved.

Synopsis

 eosinophilic infiltrate of the gastric chorion
 eosinophils in gastric surface epithelium and gastric glandular epithelium

Etiology

 isolated eosinophilic gastritis
 associated eosinophilic gastritis

• eosinophilic gastrointestinal disorders
• eosinophilic gastroenteritis

 allergic reactions (allergic gastritis)
 peptic ulcers
 drug reactions
 gastric Crohn disease (Crohn gastritis)
 parasite reactions
 foreign bodies
 allergic granulomatosis
 gastric adenomas
 chronic granulomatous disease
 gastric carcinomas
 Langerhans cell histiocytosis
 varioliform gastritis
 gastric T-cell lymphoma
 inflammatory fibroid polyp
 eosinophilic gastroenteritis

See also

 Gastritis

• chronic gastritis

 eosinophilic inflammation
 eosinophilic disorders