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Logo of aaciBioMed CentralBiomed Central Web Sitesearchsubmit a manuscriptregisterthis articleAllergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology
 
Allergy Asthma Clin Immunol. 2012; 8(Suppl 1): A6.
Published online Nov 2, 2012. doi:  10.1186/1710-1492-8-S1-A6
PMCID: PMC3487875
Eosinophilic gastroenteritis with gastric and small bowel involvement: successful treatment with oral budesonide
Mohammad Alsayegh1 and Douglas Mackcorresponding author2
1Department of Medicine, Mubarak Al-Kabeer Hospital, Kuwait
2Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
corresponding authorCorresponding author.
Mohammad Alsayegh: q8imo/at/yahoo.com; Douglas Mack: dougpmack/at/gmail.com
Supplement
Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2012
Publication of this supplement was supported by the CSACI.
Conference
Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2012
11-14 October 2012
Calgary, Canada
Introduction
Eosinophilic gastroenteritis (EGE) is an uncommon gastrointestinal disorder. The manifestations of EGE are varied and steroids are the mainstay of treatment. To our knowledge we present the first case of successful treatment of pediatric EGE with both budesonide in oral suspension and enteric-coated budesonide.
A 16 year old female with a chronic history of mild abdominal discomfort presented with acute severe abdominal pain. Her absolute eosinophil count was elevated as was her total IgE. Skin testing, serology and other bloodwork were negative. Computed tomography scan of abdomen and pelvis showed diffuse thickening of the duodenum. Histopathological studies of gastric and duodenal biopsies revealed heavy eosinophilic infiltration. She had improvement on prednisone however the patient's symptoms relapsed after discontinuing. Her symptoms were then controlled on a daily dose of 11 mg of oral budesonide in two different formulations. 2 mg of daily budesonide was given in the form of sweetened oral suspension and 9 mg of daily budesonide was given in the form of enteric coated (EC) budesonide oral tablets The patient reported significant improvement of symptoms within 5 days of starting the budesonide combination. The patient continued budesonide treatment for one month. She has been asymptomatic to 13 months following treatment with follow up endoscopy revealing full resolution of eosinophilic infiltration.
Conclusion
Oral budesonide can be useful in the treatment of EGE. We suggest that careful selection of budesonide formulations for EGE treatment is important to ensure correct drug delivery to the affected gut.
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