Vitamin D deficiency causing eosinophilic esophagogastroenteritis and ascites: A rare association

Qua, Choon-Seng and Peh, Kaik-Boo and Saravannan, Kannan and Goh, Khean-Lee (2021) Vitamin D deficiency causing eosinophilic esophagogastroenteritis and ascites: A rare association. BMJ Case Reports, 14 (2). ISSN 1757-790X, DOI https://doi.org/10.1136/bcr-2020-240039.

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Abstract

A 54-year-old Chinese man presented with ascites for 2 weeks. He had a preceding 2-year history of intermittent dysphagia, lethargy and general malaise. Blood investigations revealed leucocytosis with eosinophilia of 26.5%, whereas paracentesis showed turbid fluid with high protein content (45g/L) and a high white blood cell count of 5580/mu L, predominantly eosinophils (90%). An incidental assay of vitamin D showed a very low level of 13.5ng/mL. No other cause of ascites was found. Gastroscopy was normal except for duodenitis. However, biopsies from lower oesophagus confirmed the presence of eosinophilic infiltration. Following vitamin D replacement, the patient experienced marked improvement in symptoms of dysphagia within 2 weeks and no recurrence of ascites after 3 months. The reason for the patient's vitamin D deficiency remains unclear. The marked improvement in the patient's health indicates a causative role of vitamin D deficiency in causing eosinophilic esophagogastroenteritis and associated eosinophilic ascites.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Stomach and duodenum; Immunology; Small intestine
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine
Divisions: Universiti Malaya Medical Centre (UMMC)
Depositing User: Ms Zaharah Ramly
Date Deposited: 01 Sep 2022 08:25
Last Modified: 01 Sep 2022 08:25
URI: http://eprints.um.edu.my/id/eprint/35168

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