PANEOSINOPHILIC ESOPHAGITIS AND GASTROENTRITIS AS A CAUSE OF ASCITIS AND WEIGHT LOSS IN YOUNG ADOLESCENT

Case scenario:

Male patient aged 16 years old presented to (department of endemic gastroenterology and hepatology, Mansoura University Hospital, Egypt) with abdominal pain, epigastric associated with distention and weight loss not associated with vomiting or change in bowel motions by local examination reveal no organomegaly or lymphadenopathy blood picture indicate Leukocytosis mainly Eosinophils (58%) ESR 5 serum albumin 4.1 serum bilirubin 0.5 serum creatinine 0.9 no evidence of parasitic infestation by stool analysis abdominal ultrasonography revealed mild ascites with average sized homogeneous echopattern of the liver and normal size and shape of spleen and both kidneys Computed Tomography revealed increase mucosal thickness of lower end esophagus, antrum of stomach and small intestinal loops with largest diameter at terminal ileum reaching 12 mm with mild amount of free fluid in abdomen and pelvis Upper GI Endoscopy delineate esophageal multiple small longitudinal furrows with minute white patches, the antrum of stomach showed exaggerated mucosal folds with congestion and duodenum showed swollen oedematous congested mucosa with biopsies sent to pathologist approved nonspecific esophagitis and enteritis with preserved villous pattern with infiltration of lamina propria by excess eosinophils > 20/HPF picture suggestive of eosinophilic esophagitis and gastroenteritis.