Pitfalls in diagnosing acute

44 mU/ml (normal 9–30), erythrocyte sedimentation rate 29 mm, and C reactive protein 9.19 mg/l (normal 0.00–6.00). Stool studies for ova and parasites and stool cultures were negative. Thyroid function tests, serum IgE, abdominal ultrasound, and computed tomography scan were normal. No findings of extra-abdominal malignancy were evident. Colonoscopy with terminal ileoscopy was normal, as was histology of the ileum and colon. Gastroscopy showed small ero-sions at the corpus, the antral mucosa, and the duodenal bulb. Biopsies were taken from the gastric corpus, antrum, and from the second part of the duodenum. Gastric biopsies showed H pylori infection and dense eosinophilic infiltration (29 eosinophils per high power field) of the gastric mucosa, but biopsies from the 2nd–3rd parts of the duodenum were normal. She was discharged with a diagnosis of eosinophilic gastritis and H pylori erosive gastritis, and was treated with esomeprazole (40 mg/day), amoxycillin (1 g/day), and clar- ithromycin (1 g/d) for seven days. No treatment was given for eosinophilia. There were no known reports implicating her medica-tions in the aetiology of her symptoms and so it was decided that she should remain on her regular medical treatment. Two months after completion of the eradication therapy repeat gastroscopy was normal. Gastric biopsies showed no H pylori infection and only trivial (five eosinophils per high power field) eosinophilic infiltration. symptom free, a blood count 3280 cells/ mm 3 and a eosinophilic count of cells/mm 3 No in platelet