Colite eosinofila in età pediatrica: una sfida diagnostica illustrata da due casi clinici

Eosinophilic colitis (EC) is a rare disease belonging to the group of non-esophageal eosinophilic gastrointestinal disorders (non-EoE EGIDs). The paper reports two paediatric cases that highlight the clinical heterogeneity of intestinal eosinophilia. The first case involves a 4-year-old boy presenting with severe chronic symptoms, including diarrhoea, rectal bleeding, growth retardation, rectal stenosis and severe proctitis. Histology confirmed prominent eosinophilic infiltration, requiring a colostomy and systemic corticosteroid treatment. The second case describes a 3-year-old boy with abdominal pain, distension and rectal bleeding. Histological signs of EC were secondary to a parasitic infection by Trichocephalus that was fully resolved with antiparasitic therapy. The cases described underscore that paediatric EC is likely an underdiagnosed condition with highly variable presentations. A thorough differential diagnosis encompassing infectious, allergic and immunologic aetiologies is essential to ensure early diagnosis and proper management.