Esophageal stenosis in a child with eosinophilic esophagitis: diagnosis and positive dynamics against the background of conservative therapy

Author:

Lokhmatov M. M.1,Makarova S. G.2,Fisenko A. P.3,Alhasov A. B.4,Oldakovsky V. I.3,Budkina T. N.3,Surkov A. N.3,Kulikov K. A.3,Tupylenko A. V.3,Silonyan A. L.3,Vyazankina S. S.3,Romanova E. A.3

Affiliation:

1. National Medical Research Center of Children’s Health; First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

2. National Medical Research Center of Children’s Health; Lomonosov Moscow State University

3. National Medical Research Center of Children’s Health

4. National Medical Research Center of Children’s Health; Pirogov Russian National Research Medical University

Abstract

Introduction. Currently, eosinophilic esophagitis (EoE) is a big and urgent problem for modern pediatrics. Its pathogenesis is associated with the formation of stenoses and strictures of the esophagus during a long course of the disease without treatment, which leads to serious disorders in the nutrition of children. In widespread practice, X-ray contrast examination of the esophagus is used, however, it is also necessary to perform esophagogastroduodenoscopy (EGDS) with taking multiple biopsies with morphological examination to verify the diagnosis. Materials and methods. Boy Y. 12 years, was admitted in March 2021 with complaints of difficulty in swallowing solid food, as well as poor weight gain. From the anamnesis of the disease, it is known that the phenomena of dysphagia were noted from the preschool period. Symptoms have progressed over the past year. EGDS was performed. A biopsy was taken: 6 fragments of the esophagus, 2 fragments from each third. Results. Diagnosed with eosinophilic esophagitis, complicated by esophageal stenosis. Chronic gastritis, Helicobacter pylori-not associated, incomplete remission. Chronic duodenitis, incomplete remission. Protein-energy malnutrition, mild. Appropriate treatment was prescribed. An allergological examination of the child was carried out and recommendations for nutrition were given. Against the background of the therapy, the child’s condition with pronounced positive dynamics - the appetite improved, the phenomena of dysphagia were completely stopped. When the child was re-hospitalized a month later, there was an increase in body weight (900 g) and growth (3 cm). Conclusions. The high efficiency of complex conservative therapy has been shown. The prescribed conservative treatment made it possible to avoid dilatation and bougienage of the esophagus. In this case, all three components of EoE treatment were applied: elimination diet, proton pump inhibitors, and topical corticosteroids. In the future, it is necessary to observe the allergist, taking into account the data obtained on multiple sensitization with a decision on the question of further treatment.

Publisher

LLC Global Media Technology

Subject

Gastroenterology,Hepatology

Reference11 articles.

1. Warners M.J., Oude Nijhuis R. A.B., de Wijkerslooth L. R.H., Smout A. J.P.M., Bredenoord A. J. The natural course of eosinophilic esophagitis and long-term consequences of undiagnosed disease in a large cohort. Am J Gastroenterol. 2018 Jun;113(6):836-844. doi: 10.1038/s41395-018-0052-5. Epub 2018 Apr 27. PMID: 29700481.

2. Kaibysheva V. O., Mikhaleva L. M., Nikonov E. L., Shapoval’yants S. G. Epidemiology, etiology and pathogenesis of eosinophilic esophagitis. The latest data.Russian Journal of Evidence-Based Gastroenterology. 2019;8(2):50-72. (In Russ., In Engl.). doi: 10.17116/dokgastro2019802150. Kaibysheva V. O., Mikhaleva L. M., Nikonov E. L., Shapoval'yants S. G. Epidemiologiya, etiologiya i patogenez eozinofil'nogo ezofagita. Noveishie dannye. Dokazatel'naya gastroenterologiya. 2019;8(2):50-72. doi: 10.17116/dokgastro2019802150.

3. Ryu S., Lee K. H., Tizaoui K., Terrazzino S., et al. Pathogenesis of Eosinophilic Esophagitis: A Comprehensive Review of the Genetic and Molecular Aspects.Int J Mol Sci. 2020 Sep 30;21(19):7253. doi: 10.3390/ijms21197253.

4. Chehade M., Jones S. M., Pesek R. D., et al. Phenotypic Characterization of Eosinophilic Esophagitis in a Large Multicenter Patient Population from the Consortium for Food Allergy Research. J Allergy Clin Immunol Pract. 2018;6(5):1534-1544.e5. doi:10.1016/j.jaip.2018.05.038.

5. Dellon E. S., Kim H. P., Sperry S. L., Rybnicek D. A., Woosley J. T., Shaheen N. J. A phenotypic analysis shows that eosinophilic esophagitis is a progressive fibrostenotic disease. Gastrointest Endosc. 2014;79:577-585. doi: 10.1016/j.gie.2013.10.027.

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