A mysterious case of gastroparesis: could the secret be found in a drink?

Mariabeatrice Principi, Ranaldo Nunzio, Giuseppe Ingravallo, Giuseppe Riezzo, Elisabetta Damiani, Antonio Ferrannini, Roberta Rossi, Leonardo Resta, Enzo Ierardi, Alfredo Di Leo
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Abstract

Background: Gastroparesis is a disorder characterized by delayed gastric emptying of a meal in the absence of a mechanical gastric outlet obstruction. Idiopathic gastroparesis is at least as common as diabetic gastroparesis in most case series, and the true prevalence of gastroparesis is unknown.

Results: We report here an interesting case of idiopathic gastroparesis characterized by sudden onset in a female patient. The diagnosis was confirmed by ultrasonographic study of gastric emptying and electrogastrography, by gastric endoscopy/histology, and finally by allergy tests. The disorder was found to be due to a rare cause, namely an allergic predisposition. In fact, our patient, who demonstrated an allergy to gold salts, had drunk a glass of a liqueur containing gold flakes and developed an eosinophilic aggregation in the gastric mucosa observed at gastric endoscopy/histology. The symptoms disappeared after steroid administration.

Conclusion: Our experience suggests that gastric histology and close enquiry into any history of allergy may be useful diagnostic tools in cases of idiopathic gastroparesis.

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神秘的胃轻瘫病例:能在饮料中找到秘密吗?
背景:胃轻瘫是一种以在没有机械性胃出口梗阻的情况下胃排空延迟为特征的疾病。在大多数病例系列中,特发性胃轻瘫至少与糖尿病性胃轻瘫一样常见,而胃轻瘫的真实患病率尚不清楚。结果:我们在这里报告一个有趣的特发性胃轻瘫的特点是突然发作的女性患者。经胃排空超声检查、胃电图、胃内窥镜/组织学检查和过敏试验证实诊断。这种疾病被发现是由于一种罕见的原因,即过敏倾向。事实上,我们的病人对金盐过敏,他喝了一杯含金片的利口酒,在胃内窥镜/组织学上观察到胃粘膜嗜酸性粒细胞聚集。类固醇治疗后症状消失。结论:我们的经验表明,在特发性胃轻瘫病例中,胃组织学和对任何过敏史的密切调查可能是有用的诊断工具。
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