Eosinophilic gastroenteritis (EGE) is characterized by eosinophilic infiltration of the digestive organs, most commonly of the stomach and the duodenum. Symptoms of EGE are nonspecific and include nausea, vomiting, abdominal pain, dyspepsia, malabsorption, ascites and weight loss. The various symptoms of EGE depend on its location and the depth of gastrointestinal eosinophil infiltration. We report a case presenting with acute pancreatitis caused by a milk allergy. The patient’s symptoms rapidly improved after treatment with corticosteroids, and he remained symptom-free for more than 20 months by the elimination of cow’s milk from his diet. Serum titers of pancreatic enzymes and total bilirubin simultaneously recovered and blood eosinophil counts normalized. The causative allergens of EGE are too various to detect; however, allergologic exams revealed that a cow’s milk allergy had provoked EGE in our case. Adult-onset cow’s milk allergies are rare; when seen, however, they may present severe complications such as anaphylaxis, gastroenteritis and pancreatitis. When unaccountable gastrointestinal symptoms are observed, EGE caused by food allergies should be included in the differential diagnosis.

Kaijser R: Zur Kenntnis der allergischen Affektionen des Verdauugskanals vom Standpunkt des Chirurgen aus. Arch Klin Chir 1937;188:36–64.
Talley NJ, Shorter RG, Phillips SF, Zinsmeister AR: Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues. Gut 1990;31:54–58.
Talley NJ: Eosinophilic gastroenteritis; in Feldman M, Friedman LS, Sleisenger MH (eds): Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. Philadelphia, Saunders, 2002, pp 1972–1982.
Daneshjoo R, Talley NJ: Eosinophilic gastroenteritis. Curr Gastroenterol Rep 2002;4:366–372.
Klein N, Hargrove R, Sleisenger M, Jeffries G: Eosinophilic gastroenteritis. Medicine (Baltimore) 1970;49:299–319.
Vazquez Rodriguez JJ, Soleto Saez E, Sanchez Vega J, Lopez Serrano MC, Cerdan Vallejo A: Pancreatitis and eosinophilic gastroenteritis. Int Surg 1973;58:415–419.
Smith PM, Morgans ME, Clark CG, Lennard-Jones JE, Gunnnlaugsson O, Jonasson TA: Lipidystrophy, pancreatitis, and eosinophilia. Gut 1975;16:230–234.
Bastid C, Sahel J, Choux R, Payan MJ, Sarles H: Eosinophilic pancreatitis: report of a case. Pancreas 1990;5:104–107.
Maeshima A, Murakami H, Sadakata H, Saitoh T, Matsushima T, Tamura J, Karasawa M, Naruse T: Eosinophilic gastroenteritis presenting with acute pancreatitis. J Med 1997;28:265–272.
Barthet M, Hastier P, Buckley ML, Bernard JP, Sater B, Baroni JL, Salducci J, Delmont J: Eosinophilic pancreatitis mimicking pancreatic neoplasia: EUS and ERCP findings – is nonsurgical diagnosis possible? Pancreas 1988;17:419–422.
Polyak S, Smith T, Mertz H: Eosinophilic gastroenteritis causing pancreatitis and pancreaticobiliary ductal dilation. Dig Dis Sci 2002;47:1091–1095.
Christopher V, Thompson MH, Hughes S: Eosinophilic gastroenteritis mimicking pancreatic cancer. Postgrad Med J 2002;78:498–499.
Lyngbaek S, Adamsen S, Aru A, Bergenfeldt M: Recurrent acute pancreatitis due to eosinophilic gastroenteritis. Case report and literature review. J Pancreas 2006;7:211–217.
Stone KD, Prussin C: Immunomodulatory therapy of eosinophil-associated gastrointestinal diseases. Clin Exp Allergy 2008;38:1858–1865.
Rumans MC, Lieberman DA: Eosinophilic gastroenteritis presenting with biliary and duodenal obstruction. Am J Gastroenterol 1987;82:775–778.
Farahvash MJ, Bastani B, Farahvash MR, Irvanlou G: Eosinophilic gastroenteritis presenting with biliary and partial duodenal obstruction. Am J Gastroenterol 1990;85:1022–1024.
Monhandas KM, Santhi Swaroop V, Desai DC, Jafannath P, Krishnamurthi S, DeSouza LJ: Pancreatic and biliary obstruction due to eosinophilic gastroenteritis (letter). Am J Gastoenterol 1990;85:1540–1541.
Miyamoto T, Shibata T, Matsuura S, Kagesawa M, Ishizawa Y, Tamiya K: Eosinophilic gastroenteritis with ileus and ascites. Intern Med 1996;35:779–782.
Shweiki E, West J, Klena J, Kelley S, Colley A, Bross R, Tyler W: Eosinophilic gastroenteritis presenting as an obstructing cecal mass – a case report and review of the literature. Am J Gastroenterol 1999;94:3644–3645.
Tran D, Salloum L, Tshibaka C, Moser R: Eosinophilic gastroenteritis mimicking acute appendicitis. Am Surg 2000;66:990–992.
Zhang L, Duan L, Ding S, Lu J, Cui R, McNutt M, Wang A: Eosinophilic gastroenteritis: clinical manifestations and morphological characteristics, a retrospective study of 42 patients. Scand J Gastroenterol 2011;46:1074–1080.
Rothenberg ME: Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004;113:11–28.
Blackshaw A, Levison D: Eosinophilic infiltrates of the gastrointestinal tract. J Clin Pathol 1986;39:1–7.
Rothenberg ME, Hogan SP: The eosinophil. Annu Rev Immunol 2006;24:147–174.
Desreumaux P, Bloget F, Seguy D, Capron M, Cortot A, Colombel J, Janin A: Interleukin 3, granulocyte-macrophage colony-stimulating factor, and interleukin 5 in eosinophilic gastroenteritis. Gastroenterology 1996;110:768–774.
Rothenberg ME: Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol 2004;113:11–29.
Host A: Cow’s milk protein allergy and intolerance in infancy. Pediatr Allergy Immunol 1994;5:s1.
Wal JM: Structure and function of milk allergens. Allergy 2001;56:s35.
Katz A, Goldman H, Grand R: Gastric mucosal biopsy in eosinophilic (allergic) gastroenteritis. Gastroenterology 1977;73:705–709.
Leinbach GE, Rubin CE: Eosinophilic gastroenteritis: a simple reaction to food allergens? Gastroenterology 1970;59:874–889.
Cello JP: Eosinophilic gastroenteritis – a complex disease entity. Am J Med 1979;67:1097–1104.
Chen M, Chu C, Lin S, Shih S, Wang T: Eosinophilic gastroenteritis: clinical experience with 15 patients. World J Gastroenterol 2003;9:2813–2816.
Katz A, Twarog F, Zeiger R, Falchuk Z: Milk-sensitive and eosinophilic gastroenteropathy: similar clinical features with contrasting mechanisms and clinical course. J Allergy Clin Immunol 1984;74:72–78.
El Mouzen, Quorain AA, Anim JT: Cow’s-milk induced erosive gastritis in an infant. J Pediatr Gastroenterol Nutr 1990;10:111–113.
Esteve C, Resano A, Diaz-Tajeiro P, Fernandez-Benitez M: Eosinophilic gastritis due to Anisakis: a case report. Allegol Immunopathol (Madr) 2000;28:21–23.
Klein NC, Hargrove RL, Sleisenger MH, Jeffries GH: Eosinophilic gastroenteritis. Medicine 1970;49:299–319.
Simon D, Straumann A, Wenk A, Spichtin H, Simon HU, Braathen LR: Eosinophilic esophagitis in adults – no clinical relevance of wheat and rye sensitization. Allergy 2006;61:1480–1483.
de Chambrun GP, Gonzalez F, Canva JY, Gonzalez S, Houssin L, Desreumaux P, Cortot A, Colombel JF: Natural history of eosinophilic gastroenteritis. Clin Gastroenterol Hepatol 2011;9:950–956.
Chen MJ, Chu CH, Lin SC, Wang TE: Eosinophilic gastroenteritis: clinical experience with 15 patients. World J Gastroenterol 2003;9:2813–2816.
Lee M, Hodges WG, Huggins TL, Lee FL: Eosinophilic gastroenteritis. South Med J 1996;89:189–194.
Neustrom MR, Friesen C: Treatment of eosinophilic gastroenteritis with montelukast. J Allergy Clin Immunol 1999;104:506.
Pérez-Millán A, Martín-Lorente J, López-Morante A, Yuguero L, Sáez-Royuela F: Subserosal eosinophilic gastroenteritis treated efficaciously with sodium cromoglycate. Dig Dis Sci 1997;42:342–344.
You do not currently have access to this content.