Methods: A 59-year-old man was admitted to this hospital with a chief complaint of dyspnea that developed five years ago. His symptom was not particularly exacerbated in any season, and he showed no signs of orthopnea, generalized edema, chest pain nor palpitation. The initial laboratory data showed that WBC 5520/µ°(with 50.1% neutrophil, 38.2% lymphocyte, 6.8% monocyte, 4.5% eosinophil and 0.4% basophil); hemoglobin, 15.8 g/dL;BUN, 25.6 mg/dL; creatinine, 0.84mg/dL; sodium, 139mmol/L; potassium, 4.4mmol/L; chloride, 105mmol/L. The ECG showed normal sinus rhythm. The chest radiograph was within normal limits. Pulmonary function test showed FEV1, 101% of predicted while FVC 127% of predicted. The methacholine provocation test and skin prick test was negative. Through these tests we concluded that the patient’s dyspnea was from neither pulmonary nor cardiac origin. Besides he had suffered an uncontrolled five-time-a-day watery diarrhea and tenesmus for the last fifteen years. we could guess that his dyspnea might have developed secondary to chronic diarrhea. Under a suspicion of EGE based on the eosinophil level of 250/µ° and uncontrollable diarrhea, He underwent colonoscopy.
Results: Colonoscopy showed no visual abnormalities, but biopsies of colon and rectum were performed for the diagnosis of eosinophil infiltration. The histopathologic test showed eosinophil infiltrations. The final diagnosis was EGE presenting as dyspnea in an adult. The patient was treated with methylprednisolone and he had neither recurrent diarrhea nor tenesmus. The patient has been asymptomatic for about 3 month after discharge.
Conclusions: For eosinophilic gastroenteritis presenting dyspnea in adult patient has not been previously reported in the literature, we thought this could guide diagnosis in future cases.