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A woman with intermittent left-sided abdominal pain was diagnosed with eosinophilic gastroenteritis of the serous membrane. Gastroenteritis refers to an inflammation of the stomach and intestines. Eosinophils are a type of white blood cell. Serous membranes are thin tissues that line different bodily cavities, in this case part of the small intestine. The patient had suffered from crampy abdominal pain lasting one or two days over a course of two years. On admission to the hospital, her pain was more severe on the upper left side of her abdomen. X-rays and CT scans revealed thickened loops in the small bowel. The mesentery, another part of the intestine, was also inflamed. The diagnosis of eosinophilic gastroenteritis, serosal form, was made after surgical removal of part of the colon. Eosinophils were present in large numbers in the serosal tissue. There was no evidence of parasitic infection. The presence of eosinophils, the non-specific gastrointestinal symptoms and the lack of parasitic infection or other disease were the criteria used to confirm the diagnosis.

Eosinophilic pustular folliculitis (EPF) of infancy is a skin disorder characterized by the formation of red pustules primarily on the scalp and brow. Folliculitis is the inflammation of hair follicles and may be infectious or non-infectious. As of Feb, 1993, there have been 28 reported cases of EPF, and most have been in male infants. Nine infants, seven of whom were male, were diagnosed with EPF. Pustular samples taken from the infants showed no signs of bacterial or fungal infection. The samples had high concentrations of eosinophils, a type of white blood cell. Most of the infants had leukocytosis, which is an increase in the number of circulating white blood cells, and eosinophilia, which is an abnormal increase in the concentration of eosinophils in the blood. The cause of EPF is still unknown, but most of the infants responded to treatment with topical corticosteroids or topical antibiotics.

A 24-year-old man was diagnosed with eosinophilic gastritis. Eosinophilic gastritis is inflammation of the stomach involving the infiltration of eosinophils, a type of white blood cell. The patient was admitted to the hospital with nausea and stomach pain after undergoing treatment for a hernia. He had been treated for asthma with corticosteroid drugs since childhood and ha experienced occasional difficulty in swallowing and nausea, vomiting and abdominal pain after meals for a number of years. Examination of the patient's gastrointestinal tract did not reveal any abnormalities. A tissue biopsy from his gastrointestinal tract, however, showed that he had allergic eosinophilic gastritis that may have been caused by food allergies. He was treated with prednisone for two weeks, and maintained on oral cromolyn sodium. His symptoms subsided and he gained weight.

Recently, sporadic cases of eosinophilia in conjunction with other systemic symptoms have been associated with the use of tryptophan as a dietary supplement. Eosinophilia refers to an abnormal number of eosinophils (a type of white blood cell) in the blood; tryptophan is an amino acid that is found in dietary protein and is also available as an over-the-counter product for treating insomnia and premenstrual syndrome (PMS). Although an association has been made between tryptophan and eosinophilic connective-tissue disease, the cause is still unknown. Contamination in the tryptophan manufacturing process has been suggested as a possible cause. However, no evidence has been discovered to support this. It has also been suggested that the condition may be a result of abnormalities in tryptophan metabolism. In an attempt to devise a model for this syndrome, seven patients were examined who developed eosinophilia, connective tissue disease, and cutaneous (skin) abnormalities while taking tryptophan. Symptoms and characteristics of these individuals are described. Use of tryptophan was discontinued and the patients were treated with corticosteroids, which provided relief of some symptoms. Other symptoms included pulmonary symptoms, fever, and myopathy (muscle disorders). Similarities between the patients with this disorder and conditions that involve tryptophan metabolites were noted. Because of the limited number of cases of this syndrome that have been reviewed, it is likely that not all of the manifestations of this disorder have been examined. No clear explanation for this condition is evident, and the possibility of a contaminant still cannot be ruled out. Further research on tryptophan metabolism, as well as on the cause and progression of tryptophan-associated eosinophilia, is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)