Eosinophilic Gastroenteritis during Tocilizumab Treatment for Castleman Disease

Eosinophilic gastroenteritis (EGE) is a rare inflammatory disorder characterized by eosinophilic infiltration of the gastrointestinal tract and its associated symptoms. We report a case of EGE in a patient with idiopathic multicentric Castleman disease and asthma, who developed gastrointestinal symptoms and eosinophilia during tocilizumab therapy. Endoscopy revealed marked gastric mucosal injury and biopsy confirmed eosinophilic infiltration. Despite normal intestinal endoscopic findings, the biopsy specimens revealed eosinophilic infiltration. The discontinuation of tocilizumab and initiation of prednisolone resulted in complete symptom resolution, suggesting that the onset of EGE may have been associated with tocilizumab treatment.