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Purpose: Eosinophilic gastrointestinal diseases represent a rare and diverse group of conditions. Given that the pathogenesis of EoC is not well understood and is often linked to allergic conditions, this case underscores the necessity for further research into such unique presentations. The patient's prolonged gastrointestinal symptoms presented a significant diagnostic challenge, emphasizing the importance of ruling out various potential causes for elevated blood eosinophils. This exploration aims to enhance the understanding of such rare clinical scenarios and improve diagnostic accuracy in similar cases., Case Description: We present a unique case of a 57-year-old patient with a medical history of asthma and allergic rhinitis who presented recurrent abdominal pain, significant blood eosinophilia, and elevated levels of Immunoglobulin G4. After ruling out hematological and secondary causes of eosinophilia, a biopsy of the colon mucosa revealed an excess of tissue eosinophils, confirming the diagnosis of EoC. The patient responded well to corticosteroids and was subsequently maintained on montelukast, with no recurrence of symptoms over 3 months., Conclusion: This rare confluence of EoC, asthma, and high levels of serum IgG4 in a single patient contributes to our understanding of these complex and interconnected disorders., Competing Interests: Qui Huu Nguyen and Tram Que Nguyen Pham are co-first authors. The authors declare they have no competing interest for this study., (© 2024 Nguyen et al.)

Eosinophilic gastroenteritis poses a significant diagnostic challenge, particularly in developing countries, where the awareness of this condition may be limited. Here, the case of a patient in her early 30s, who presented with recurrent episodes of abdominal pain and diarrhea, is reported. Initial standard laboratory investigations revealed normal complete blood counts and elevated total serum immunoglobulin E levels. Upper and lower endoscopic evaluations with systemic biopsies did not reveal any significant abnormalities. However, computed tomography revealed a thickened small intestine wall, halo signs, and mild ascites. Analysis of the ascitic fluid confirmed eosinophilia. These findings prompted a diagnosis of eosinophilic gastroenteritis. The patient responded well to a targeted elimination diet, corticosteroids, and antileukotriene medication. The present case emphasizes the importance of considering eosinophilic gastroenteritis in the differential diagnosis of patients who present with abdominal pain and eosinophilic ascites., Competing Interests: Declaration of conflicting interestThe authors declare that there are no conflicts of interest.