Upper Gastrointestinal Bleeding as the First Presentation of Eosinophilic Gastrointestinal Disease

JPGN Rep. 2020 Nov 11;1(2):e017. doi: 10.1097/PG9.0000000000000017. eCollection 2020 Nov.

Abstract

Gastrointestinal bleeding is a rare but potentially life-threatening manifestation of eosinophilic gastrointestinal disorders (EGIDs). Here, we describe a case series comprising 5 pediatric patients between 7 and 12 years of age, who presented to the emergency department with hematemesis and were subsequently diagnosed with EGID. Accompanying allergic history, peripheral eosinophilia, and total IgE elevation were common. Despite a more severe presentation, response to medical and dietary therapy was favorable. A comprehensive review of the literature revealed 26 other cases with similar findings that reinforced the importance of prompt recognition and early dietary and immunomodulating therapy in the control of this disease.

Keywords: budesonide; children; eosinophilic esophagitis; esophageal ulcer; hematemesis; upper GI bleeding.