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Vitamin D deficiency causing eosinophilic esophagogastroenteritis and ascites: a rare association
  1. Choon-Seng Qua1,
  2. Kaik-Boo Peh2,
  3. Kannan Saravannan1 and
  4. Khean-Lee Goh3
  1. 1Gastroenterology, Mahkota Medical Centre, Melaka, Melaka, Malaysia
  2. 2Pathology, Mahkota Medical Centre, Melaka, Malaysia
  3. 3Medicine, University of Malaya, Kuala Lumpur, Malaysia
  1. Correspondence to Professor Khean-Lee Goh; klgoh56{at}


A 54-year-old Chinese man presented with ascites for 2 weeks. He had a preceding 2-year history of intermittent dysphagia, lethargy and general malaise. Blood investigations revealed leucocytosis with eosinophilia of 26.5%, whereas paracentesis showed turbid fluid with high protein content (45 g/L) and a high white blood cell count of 5580/µL, predominantly eosinophils (90%). An incidental assay of vitamin D showed a very low level of 13.5 ng/mL. No other cause of ascites was found. Gastroscopy was normal except for duodenitis. However, biopsies from lower oesophagus confirmed the presence of eosinophilic infiltration. Following vitamin D replacement, the patient experienced marked improvement in symptoms of dysphagia within 2 weeks and no recurrence of ascites after 3 months. The reason for the patient’s vitamin D deficiency remains unclear. The marked improvement in the patient’s health indicates a causative role of vitamin D deficiency in causing eosinophilic esophagogastroenteritis and associated eosinophilic ascites.

  • stomach and duodenum
  • immunology
  • small intestine

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  • Contributors The patient was under the care of C-SQ. Report was written by C-SQ and K-LG with contributions by KS and K-BP for the figures.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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