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CT imaging features of eosinophilic colitis in children

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Abstract

Background

Eosinophilic colitis (EC) is a gastrointestinal disease of undetermined etiology whose clinical features overlap with those of the inflammatory bowel diseases. To the best of our knowledge, the CT imaging features of EC have not been described in children.

Objective

To report and analyze the clinical, imaging and histological findings in seven children with EC.

Materials and methods

Children with EC were identified in a pediatric pathology database, and those with CT imaging within 2 months of diagnosis were included, totaling seven children. Clinical, imaging and pathological features were reviewed and analyzed.

Results

The most common presenting symptoms were abdominal pain, bloody diarrhea and rectal bleeding. EC was characterized as a dense and predominantly eosinophilic inflammatory infiltrate in the lamina propria or epithelium without granulomas. CT scans were abnormal in six children (86%), demonstrating colonic wall thickening, predominantly cecal, in five (71%), mild to moderate terminal ileal thickening in two (29%), and pneumatosis in one (14%). Right colonic involvement was greater than terminal ileal involvement.

Conclusion

CT imaging findings in children with EC include right colonic wall thickening of variable extent downstream and absent or mild involvement of the terminal ileum. EC should be considered in the differential diagnosis in children presenting with abdominal pain and bloody diarrhea.

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Authors and Affiliations

  1. Department of Radiology, Children’s Hospital Colorado, 13123 E. 16th Ave., Aurora, CO, 80045, USA

    Jonathan L. Brandon & Laura Z. Fenton

  2. Department of Pediatrics, Gastrointestinal Eosinophilic Diseases Program, University of Colorado Denver School of Medicine, Aurora, CO, USA

    Shauna Schroeder, Glenn T. Furuta, Kelley Capocelli & Joanne C. Masterson

  3. Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children’s Hospital Colorado, Aurora, CO, USA

    Shauna Schroeder, Glenn T. Furuta & Joanne C. Masterson

  4. Department of Pediatrics, National Jewish Health, Denver, CO, USA

    Shauna Schroeder, Glenn T. Furuta & Joanne C. Masterson

  5. Department of Pathology, Children’s Hospital Colorado, Aurora, CO, USA

    Kelley Capocelli

Authors
  1. Jonathan L. Brandon
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  2. Shauna Schroeder
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  3. Glenn T. Furuta
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  4. Kelley Capocelli
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  5. Joanne C. Masterson
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  6. Laura Z. Fenton
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Corresponding author

Correspondence to Jonathan L. Brandon.

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Brandon, J.L., Schroeder, S., Furuta, G.T. et al. CT imaging features of eosinophilic colitis in children. Pediatr Radiol 43, 697–702 (2013). https://doi.org/10.1007/s00247-012-2615-8

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  • DOI: https://doi.org/10.1007/s00247-012-2615-8

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