Eosinophilic gastroenteritis is an idiopathic inflammatory lesion of the gastrointestinal tract characterized by eosinophilic infiltration of the stomach and/or intestine. The clinical symptoms of this disease are similar to other pathologies of the gastrointestinal tract, so it was not diagnosed and was considered a rare disease. The most likely underlying cause is type I hypersensitivity to food and its components and can be associated with other allergic diseases. The main three criteria remain relevant for the diagnosis: the presence of long-term symptoms of gastrointestinal disease; histological data on eosinophilic infiltration in one or more areas of the gastrointestinal tract and the exclusion of other causes of eosinophilia. Generally, peripheral eosinophilia is revealed in 70-90% of patients, which is more pronounced in the serous subtype of eosinophilic gastroenteritis. The absence of peripheral eosinophilia is an insufficient criterion for the exclusion of eosinophilic gastroenteritis, so to diagnose eosinophilic gastroenteritis endoscopic and histological methods are required. Endoscopic study may not reveal changes in the stomach and intestine, though the signs of chronic inflammation can be pronounced. Apart from visualization of mucosal changes, a biopsy should be performed on at least five to six areas of normal and altered mucosa. In patients with symptoms of esophageal and colon lesions, additional biopsy specimens should be taken from the appropriate areas. Histopathological study of gastric and duodenal biopsies is crucial in the diagnosis of eosinophilic gastroenteritis and should be based on the detection of eosinophilic infiltration of the mucous membrane. There is no generally accepted threshold for the number of eosinophils, since they are normally presented in the wall of the gastrointestinal tract. The most acceptable eosinophil count is greater 20 cells in the field of view in at least one sample of the biopsy. However, these data do not take into account the age of a patient and the part of the gastrointestinal tract from which the biopsy was taken. Conclusion. The cooperation of clinicians, endoscopists and pathologists can contribute to the diagnosis of the disease. Moreover, the search for new diagnostic criteria, including molecular, histochemical and immunohistochemical methods of study, which will expand knowledge of the pathogenesis, morphology and treatment of eosinophilic gastroenteritis, remains relevant.
Keywords: eosinophilic infiltration, functional dyspepsia, endoscopic study, pathohistology, immunohistochemistry
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