Study on Gastrointestinal Disease
Eosinophilic esophagitis in children: analysis of 22 cases
Sun Mingfang, Gu Weizhong, Peng Kerong, Liu Mingnan, Shu Xiaoli, Jiang Liqin, Jiang Mizu
Published 2017-07-02
Cite as Chin J Pediatr, 2017,55(07): 499-503. DOI: 10.3760/cma.j.issn.0578-1310.2017.07.006
Abstract
ObjectiveEosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal disease.The current domestic reports of EoE in children is rare.The aim of this study was to analyze the clinical features, the diagnosis and treatment advance of EoE in children by case analysis and literature review.
MethodClinical data of 22 children with EoE from January, 2011 to December, 2015 in Children′s Hospital, Zhejiang University School of Medicine were recorded, retrospective analysis was performed on clinical presentation, gastroendoscopy and histopathological examination features and the treatment.
Result(1) Clinical data: EoE can occur at any age in children (5 months to 13 years). The most common clinical manifestations of EoE are vomiting and abdominal pain, 45% (10/22) and 41%(9/22) respectively. (2) Endoscopy and pathological features of esophageal mucosa: 11 cases with coarse mucous membrane (50%), 6 cases with congestion or erosion of esophageal membrane (27%), 5 cases with longitudinal crack (23%), 3 cases with ring uplift (14%), 3 cases with granular uplift (14%), 3 cases with normal mucosa(14%). Histopathologic manifestation is eosinophil infiltration and the eosinophil counts were all more than or equal to 15/HP. (3) Laboratory results: 13 cases had increasing eosinophil counts and eosinophils proportion (62%). (4)Allergy history: among 22 cases, 7 patients had allergy history (32%). (5) Situation of treatment and remission: 16 cases had clinical remission by oral omeprazole; 2 cases had clinical remission by oral Omeprazole and Montelukast sodium; 1 case acquired remission by elimination diet; 1 case acquired remission by elimination diet and oral prednisone. 2 cases dropped out; Only 2 patients received gastroendoscopy re-examination after 3 months and revealed esophageal mucosal histologic complete recovery.
ConclusionThe clinical symptoms of EoE in children varies.Esophageal mucosal features of gastroendoscopy examination in children with EoE were longitudinal crack, white exudates or plaques, paper mucosa, ring uplift and granular uplift.Most patients could achieve remission by using proton-pump inhibitors, only few children needed elimination diet and change formula, or even oral glucocorticoids.
Key words:
Eosinophilic esophagitis; Treatment outcome; Child; Clinical features
Contributor Information
Sun Mingfang
Department of Gastroenterology, Children′s Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
Gu Weizhong
Peng Kerong
Liu Mingnan
Shu Xiaoli
Jiang Liqin
Jiang Mizu
