Mastocytic enterocolitis as a possible cause of chronic diarrhea

Česká verzia

Authors: M. Bysterská ^1,2; J. Šťovíček ^1,3
Authors place of work: Gastroenterologická ambulance, ResTrial GastroEndo, s. r. o., Praha ¹; Gastroenterologická ambulance, Poliklinika Budějovická, Medicon, a. s., Praha ²; Interní klinika 2. LF UK a FN Motol, Praha ³
Published in the journal: Gastroent Hepatol 2018; 72(4): 317-319
Category: Klinická a experimentální gastroenterologie: kazuistika
doi: https://doi.org/10.14735/amgh2018317

Summary

The importance of mast cells in the gastrointestinal tract is well known. In addition to their role in allergic reactions and in defense against microbial and parasitic infections, they also play an important role in regulating visceral sensitivity and vascular permeability. Several studies have addressed the concentration of mast cells in the mucosa of patients with intractable cryptogenous chronic diarrhea and patients diagnosed with diarrhea-predominant irritable bowel syndrome. A new term, mastocytic enterocolitis, is used for a subset of patients with chronic intractable diarrhea with increased mast cells infiltration into the gut mucosa. The etiology is unclear. It is also unclear whether the accumulation of mast cells in the intestinal mucosa is a consequence or cause of mucosal inflammation. Regarding diagnosis, it is important to consider that intestinal biopsy samples may appear unremarkable on routine hematoxylin-eosin staining but show increased numbers of mast cells after immunohistochemistry for CD117 or mast cell tryptase. In this article we report the case of a 47-year-old female patient suffering from intractable diarrhea for 8 months, where the only pathologic finding was increased mast cell infiltration of gut mucosa. The patient was successfully treated with topical corticoids and antihistamines.

Key words:

mast cells – irritable bowel syndrome – mastocytic enterocolitis – chronic intractable diarrhea

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted: 20. 2. 2018

Accepted: 16. 3. 2018

Zdroje

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