Carbimazole-induced eosinophilic gastroenteritis in a young female with abdominal pain and ascites: a case report

Abstract Background Eosinophilic gastroenteritis is a rare disease characterized by eosinophilic infiltration into one or more layers of the gastrointestinal tract. It commonly affects children more than adults. The clinical features depend on the site of gut involvement, but the most common symptom...

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Main Authors: Khadija Hafidh, Touseef Kazmi, Abeer Alhaj, Zufana Nazir
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Journal of Medical Case Reports
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Online Access:https://doi.org/10.1186/s13256-024-04866-9
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author Khadija Hafidh
Touseef Kazmi
Abeer Alhaj
Zufana Nazir
author_facet Khadija Hafidh
Touseef Kazmi
Abeer Alhaj
Zufana Nazir
author_sort Khadija Hafidh
collection DOAJ
description Abstract Background Eosinophilic gastroenteritis is a rare disease characterized by eosinophilic infiltration into one or more layers of the gastrointestinal tract. It commonly affects children more than adults. The clinical features depend on the site of gut involvement, but the most common symptoms include abdominal pain and diarrhea. The most common cause reported in the literature is hypersensitivity, as many patients have a history of seasonal allergies, atopy, asthma, food allergies, and so on. However, drugs can be a rare triggering factor. In the literature review, we found multiple case reports of eosinophilic gastroenteritis; however, only one other case of carbimazole-induced eosinophilic gastritis has been reported. Case presentation We report herein the case of a 36-year-old female from the Philippines who developed eosinophilic gastroenteritis localized to the esophagus and ileum 12 months following treatment with carbimazole for hyperthyroidism. In our facility, she was extensively investigated for malignancy, autoimmune pathologies and infectious etiologies. As the symptoms coincided with carbimazole exposure and other causes were ruled out, we labeled her as carbimazole-induced eosinophilic gastroenteritis. On subsequent follow-up after discharge, her symptoms and eosinophilia resolved when carbimazole was discontinued, suggesting a causative role. This is the first case of eosinophilic gastroenteritis secondary to carbimazole encountered in our region. Conclusion Diagnosis of eosinophilic gastroenteritis requires three criteria, namely (1) presence of gastrointestinal symptoms, (2) histologic evidence of eosinophilic infiltration in one or more areas of the gastrointestinal tract, and (3) exclusion of other causes of tissue eosinophilia. Our patient fulfilled all the criteria; additionally, she had a positive history of atopic tendencies and drug exposure. The diagnosis of hyperthyroidism was established a year ago and in another facility, so we were not sure of the underlying etiology of hyperthyroidism. Upon subsequent follow-up, her thyroid function remained stable. The case highlights the need for a collaborative multidisciplinary approach toward managing rare conditions.
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spelling doaj-art-21100d8a4c5e48a1a0d38714b46b398d2024-11-24T12:27:59ZengBMCJournal of Medical Case Reports1752-19472024-11-011811610.1186/s13256-024-04866-9Carbimazole-induced eosinophilic gastroenteritis in a young female with abdominal pain and ascites: a case reportKhadija Hafidh0Touseef Kazmi1Abeer Alhaj2Zufana Nazir3Dubai Academic Health Corporation, Rashid HospitalDubai Academic Health Corporation, Rashid HospitalDubai Academic Health Corporation, Rashid HospitalDubai Academic Health Corporation, Rashid HospitalAbstract Background Eosinophilic gastroenteritis is a rare disease characterized by eosinophilic infiltration into one or more layers of the gastrointestinal tract. It commonly affects children more than adults. The clinical features depend on the site of gut involvement, but the most common symptoms include abdominal pain and diarrhea. The most common cause reported in the literature is hypersensitivity, as many patients have a history of seasonal allergies, atopy, asthma, food allergies, and so on. However, drugs can be a rare triggering factor. In the literature review, we found multiple case reports of eosinophilic gastroenteritis; however, only one other case of carbimazole-induced eosinophilic gastritis has been reported. Case presentation We report herein the case of a 36-year-old female from the Philippines who developed eosinophilic gastroenteritis localized to the esophagus and ileum 12 months following treatment with carbimazole for hyperthyroidism. In our facility, she was extensively investigated for malignancy, autoimmune pathologies and infectious etiologies. As the symptoms coincided with carbimazole exposure and other causes were ruled out, we labeled her as carbimazole-induced eosinophilic gastroenteritis. On subsequent follow-up after discharge, her symptoms and eosinophilia resolved when carbimazole was discontinued, suggesting a causative role. This is the first case of eosinophilic gastroenteritis secondary to carbimazole encountered in our region. Conclusion Diagnosis of eosinophilic gastroenteritis requires three criteria, namely (1) presence of gastrointestinal symptoms, (2) histologic evidence of eosinophilic infiltration in one or more areas of the gastrointestinal tract, and (3) exclusion of other causes of tissue eosinophilia. Our patient fulfilled all the criteria; additionally, she had a positive history of atopic tendencies and drug exposure. The diagnosis of hyperthyroidism was established a year ago and in another facility, so we were not sure of the underlying etiology of hyperthyroidism. Upon subsequent follow-up, her thyroid function remained stable. The case highlights the need for a collaborative multidisciplinary approach toward managing rare conditions.https://doi.org/10.1186/s13256-024-04866-9EosinophiliaGastroenteritisAscitesDrug-induced
spellingShingle Khadija Hafidh
Touseef Kazmi
Abeer Alhaj
Zufana Nazir
Carbimazole-induced eosinophilic gastroenteritis in a young female with abdominal pain and ascites: a case report
Journal of Medical Case Reports
Eosinophilia
Gastroenteritis
Ascites
Drug-induced
title Carbimazole-induced eosinophilic gastroenteritis in a young female with abdominal pain and ascites: a case report
title_full Carbimazole-induced eosinophilic gastroenteritis in a young female with abdominal pain and ascites: a case report
title_fullStr Carbimazole-induced eosinophilic gastroenteritis in a young female with abdominal pain and ascites: a case report
title_full_unstemmed Carbimazole-induced eosinophilic gastroenteritis in a young female with abdominal pain and ascites: a case report
title_short Carbimazole-induced eosinophilic gastroenteritis in a young female with abdominal pain and ascites: a case report
title_sort carbimazole induced eosinophilic gastroenteritis in a young female with abdominal pain and ascites a case report
topic Eosinophilia
Gastroenteritis
Ascites
Drug-induced
url https://doi.org/10.1186/s13256-024-04866-9
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