Eosinophilic Proctocolitis

Differential Diagnosis

Eosinophilic Esophagitis	Eosinophilic Gastroenteritis	Eosinophilic Proctocolitis
Confined to esophagus	Involves stomach and/or small intestine	Confined to rectum and colon
Good response to dietary manipulation	Poor response to dietary manipulation	Good response to dietary manipulation

Eosinophilic (Allergic) Proctocolitis	Ulcerative Colitis
May occur <12 months of age	Very rare <12 months
Marked tissue eosinophilia >60/10 HPF	May have moderate numbers of eosinophils

Drug related must be ruled out clinically
Hypereosinophilic syndrome
- Requires >1500 eosinophils / microliter
Parasitic disease must be ruled out by stool examination
Crohn disease
- May contain many eosinophils in the infiltrate but they do not predominate
Milk protein enteropathy must be ruled out clinically
Inflammatory fibroid polyp
- Isolated polypoid lesion
- Very rare in infants
Systemic diseases
- Churg Strauss vasculitis
- Polyarteritis nodosa
- Scleroderma
- Stevens-Johnson syndrome
Graft versus host disease