Enalapril-induced eosinophilic gastroenteritis

Eosinophilic gastroenteritis is a rare disorder of unknown etiology. We des cribe a case of a 63-year-old woman with chronic diarrhea and eosinophilia. Small bowel biopsy revealed eosinophils in large clusters in the lamina pr opria with focal infiltration of the epithelium. The patient's diarrhea and eosinophilia started shortly after enalapril was prescribed. When the pati ent was instructed to stop taking that drug, her diarrhea promptly ceased, and the blood eosinophil level returned to normal. This is the first report ed case of eosinophilic gastroenteritis associated with an angiotensin-conv erting enzyme inhibitor. Eosinophilic gastroenteritis should be entertained in the differential diagnosis of patients taking angiotensin-converting en zyme inhibitors who develop diarrhea or other gastrointestinal symptoms.