Successful Treatment of Eosinophilic Gastroenteritis with Clarithromycin
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Eosinophilic gastroenteritis (EGE) is an uncommon disease characterized by eosinophilic infiltration of the gastrointestinal tract, which is usually associated with abdominal pain, diarrhea, ascites, and peripheral eosinophilia. Steroids remain the mainstay of treatment for EGE, but symptoms often recur when the dose is reduced. Macrolides have immunomodulatory effects as well as antibacterial effects. The immunomodulatory effect results in inhibition of T-lymphocyte proliferation and triggering of T-lymphocyte and eosinophil apoptosis. Macrolides also have a steroidsparing effect through their influence on steroid metabolism. We report a rare case of EGE, which relapsed on steroid reduction but improved following clarithromycin treatment.
Abstract
Eosinophilic gastroenteritis (EGE) is an uncommon disease characterized by eosinophilic infiltration of the gastrointestinal tract, which is usually associated with abdominal pain, diarrhea, ascites, and peripheral eosinophilia. Steroids remain the mainstay of treatment for EGE, but symptoms often recur when the dose is reduced. Macrolides have immunomodulatory effects as well as antibacterial effects. The immunomodulatory effect results in inhibition of T-lymphocyte proliferation and triggering of T-lymphocyte and eosinophil apoptosis. Macrolides also have a steroidsparing effect through their influence on steroid metabolism. We report a rare case of EGE, which relapsed on steroid reduction but improved following clarithromycin treatment.
참고문헌 (10)
- Ishimatsu Y, "Macrolide antibiotics induce apoptosis of human peripheral lymphocytes in vitro", Int J Antimicrob Agents, 24, pp.247~253 (2004)
- Wu L, "Immunomodulatory effects of erythromycin and its derivatives on human T-lymphocyte in vitro", Immunopharmacol Immunotoxicol, 29, pp.587~596 (2007)
- Adachi T, "Eosinophil apoptosis caused by theophylline, glucocorticoids, and macrolides after stimulation with IL-5", J Allergy Clin Immunol, 98(6), pp.S207~S215 (1996)
- Amayasu H, "Clarithromycin suppresses bronchial hyperresponsiveness associated with eosinophilic inflammation in patients with asthma", Ann Allergy Asthma Immunol, 84, pp.594~598 (2000)
- Justinich C, "Elemental diet improves steroid-dependent eosinophilic gastroenteritis and reverses growth failure", J Pediatr Gastroenterol Nutr, 23, pp.81~85 (1996)
- Verheijden NA, "A rare cause of abdominal pain: eosinophilic gastroenteritis", Neth J Med, 68, pp.367~369 (2010)
- Sheikh RA, "Unusual presentations of eosinophilic gastroenteritis: case series and review of literature", World J Gastroenterol, 15, pp.2156~2161 (2009)
- Quack I, "Eosinophilic gastroenteritis in a young girl: long term remission under Montelukast", BMC Gastroenterol, 5, pp.24~ (2005)
- Shirai T, "Successful treatment of eosinophilic gastroenteritis with suplatast tosilate", J Allergy Clin Immunol, 107, pp.924~925 (2001)
- Garrett JK, "Anti-interleukin-5 (mepolizumab) therapy for hypereosinophilic syndromes", J Allergy Clin Immunol, 113, pp.115~119 (2004)