Primary eosinophilic esophagitis.
Eosinophilic esophagitis is an uncommon pathology that generally affects children with a history of allergies and intrinsic asthma. We present a clinical case of eosinophilic esophagitis in a 16-year-old boy with upper dysphagia for solids since childhood. The analytical study showed only a repeat serum eosinophilia. Barium transit disclosed a reduction in caliber of the whole esophagus. Functional esophageal tests with pH monitoring and manometry were normal. Endoscopy showed a small-diameter esophagus and fibrosis with a very friable mucosa. The histological study of the esophageal biopsies revealed a full thickness major eosinophil infiltration of the esophagus. These findings suggest a differential diagnosis with a great variety of pathologies that can cause similar lesions in the esophagus, especially between primary eosinophilic esophagitis and eosinophilic esophagitis secondary to gastro-esophageal reflux disease (GERD). We implemented medical treatment with oral corticoids and total suppression of allergens from the diet, and the patient was asymptomatic.
Munitiz
V
V
Department of Surgery, Virgen de la Arrixaca University Hospital Murcia, Spain.
Martinez de Haro
L F
LF
Ortiz
A
A
Pons
J A
JA
Bermejo
J
J
Serrano
A
A
Molina
J
J
Parrilla
P
P
D000293:Adolescent; D000485:Allergens; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004032:Diet; D004802:Eosinophilia / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D004941:Esophagitis / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D004947:Esophagus / Q000473:pathology; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use
D000485:Allergens; D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone