Eosinophilic duodenitis misdiagnosed as acute pancreatitis in a child: a case report

Background: Eosinophilic Gastrointestinal Disorders beyond Eosinophilic Esophagitis (non-EoE EGIDs) are chronic rare inflammatory disorders characterized by eosinophilic infiltration of the gastrointestinal (GI) tract.

Case presentation: We report the first pediatric case of eosinophilic duodenitis (one type of the non-EoE EGIDs) with concomitant pancreatic reaction that was misdiagnosed as acute pancreatitis (AP). A 13-year-old girl was admitted to our hospital for a week of abdominal distension, vomiting, and epigastric pain that worsened recently. She was suspected of AP based on increased amylase and lipase values and relevant imaging findings. During hospitalization, her clinical manifestation improved, while the eosinophilia was more aggravated without a known cause. Esophagogastroduodenoscopy (EGD) was performed, and histopathological evidence demonstrated the diagnosis of Eosinophilic duodenitis, which was treated with oral prednisone tapering. During the 1-year follow-up, the patient was symptom-free and presented no signs of recurrence.

Conclusions: Although rare, pediatricians should consider non-EoE EGIDs in the differential diagnosis in children presenting with peripheral blood eosinophilia and duodenal wall thickening on imaging findings.