Non-Ige-Mediated Food Allergy May be the Cause of Chronic Bloody Diarrhea

Aims To diagnose the cause of chronic bloody diarrhea associated with weight loss in a 17-year-old female.

Methods A 17-year-old female complaining of bloody diarrhea for 2 years. The condition was associated with significant loss of weight, epigastric, and periumbilical pain. There was associated skin allergy with itching and scratch marks. Six months ago, she had hematemesis, epistaxis, and menorrhagia.

Results: Laboratory investigations showed Hb;10.9 g/dl,MCV;82,9 fL,MCH;24,6 pg;MCHC;29,7 g/dl,PLT:198000/ul, WBCs;5500, Neutrophils; 54 %,lymphocytes:42 %, Eosinophils;1,4 %, INR;1.4, APTT;31seconds,IgE;110Iu/ml(N up to 210 Iu/ml, Anti-endomysial Ab IgA, pANCA, ASCA,ASO were negative, fecal calprotectin was 26µg/mg (N up to 50 µg/mg), TSH:3 mIU/L,ESR;36 1st hour,67 2nd hour, Stool analysis showed pus cells 15-20/HPF,RBCs 20/HPF.Stool culture and sensetivity was negative. Abdominal Ultrasonography&MRI enterography showed normal examination. Upper &lower GIT endoscopy with multiple biopsies showed intact esophageal mucosa, mild superficial gastritis, mild non-specific duodenitis, mild ileal enteritis, right colon showed mild focal colitis with some eosinophils (5-10/HPF), left colon showed mild focal colitis. The patient’s symptoms improved on elemental diet & topical steroid.

Conclusions Non-IgE-mediated food allergy may be the cause of chronic bloody diarrhea associated with loss of weight.

Citation: Shabana H, Askar M eP169 NON-IGE-MEDIATED FOOD ALLERGY MAY BE THE CAUSE OF CHRONIC BLOODY DIARRHEA. Endoscopy 2021; 53: S151.

Publication History

Article published online:
19 March 2021