Subserous Eosinophilic Colitis: A Case Report in a Private Hospital in Lima, Peru

ABSTRACT

Eosinophilic colitis is a rare gastrointestinal disease that belongs to the group of so-called primary eosinophilic diseases of the digestive tract. There are three types mucosa, transmural (muscular), and subserous. We present the case of a 23-year-old male patient with a clinical picture of abdominal pain, nausea, chronic diarrhea, and ascites. Parasitic and other secondary etiologies were ruled out. Upper digestive endoscopy was not helpful. Colonoscopy revealed characteristics of inflammation in the distal ileum and ascending colon, the histological findings of which were consistent with eosinophilic colitis. The study of ascitic fluid was suggestive of eosinophilic ascites. The patient received induction treatment with prednisone 40 mg daily orally; remission was achieved after two weeks, and maintenance therapy based on prednisone was continued with the progressive withdrawal of the dose. Control of the disease was successful.

RESUMEN

La colitis eosinofílica es una patología gastrointestinal infrecuente que pertenece al grupo de las denominadas enfermedades primarias eosinofílicas del tracto digestivo. Existen 3 tipos mucosa, transmural (muscular) y subserosa. Presentamos el caso de un paciente varón, de 23 años de edad, con un cuadro clínico de dolor abdominal, náuseas, diarrea crónica y presentación de ascitis. Se descartan etiologías parasitarias y otras secundarias. La endoscopia digestiva alta no fue contribuidora. Mediante una colonoscopia se observaron características de inflamación en el íleon distal y el colon ascendente, cuyos hallazgos histológicos son compatibles con colitis eosinofílica. El estudio de líquido ascítico es sugestivo de ascitis eosinofílica. El paciente recibió tratamiento de inducción con prednisona a 40 mg diarios por vía oral, se logró la remisión a las 2 semanas y se continuó con terapia de mantenimiento a base de prednisona con retiro progresivo de la dosis. Se logró el control de la enfermedad de manera exitosa.