RESUMEN
This study was conducted to evaluate the diverse findings of endoscopy in patients that might assist in their diagnosis. Celiac disease was of special concern as it is a well known cause of short stature which can be its only presentation. A retrospective review of thirty two [32] records of children referred to the pediatric gastrointestinal clinic in Prince Ali Bin Al-Hussein Hospital in Al-Karak with short stature was done. It was conducted over six month's period. All patients were subjected to full history, physical examination and the following investigations: complete blood count, kidney function test, liver function test, thyroid function test, tissue transglutaminase antibodies and abdominal ultrasound. Upper gastrointestinal endoscopy was done to all patients whom we were not able to reach for a diagnosis, mainly to rule out celiac disease. There were 32 children included in this study, 14 female and 18 male with a mean age of 7.75 years, ranges from 2.5-13 years. Normal gross endoscopy was noticed in the majority of patients [25 patients, 78%], most of them had normal histopathological reports [19 patients, 79%]. Nevertheless, four patients out of 25 [16%] were diagnosed to have celiac disease based on the histopathology report. Abnormal endoscopy was noticed in only six patients out of 32 patients, showing D2 effacement and scalloped folds. Two of them were diagnosed to have celiac in histopathological reports [33%]. One patient only [9%] has the combination of short stature and diarrhea: Five patients were having positive tissue transglutaminase antibodies [15%], but only two of them were proved have celiac disease [40%]. Total number of patients with celiac disease in this study was six [18.75%], regardless of their gross endoscopic appearance.Short stature is a common health problem and a well-known feature of celiac disease which should be excluded to prevent serious and long term complications. Investigations should be performed to rule out organic causes including intestinal biopsy which is the gold standard for diagnosis and should be performed in every child with no apparent endocrine causes
RESUMEN
Eosinophilic esophagitis is a clincopathologic entity characterized by esophageal symptoms in association with a dense eosinophilic infiltrate, the aim of this study is to describe the clinical presentation, laboratory, endoscopic and histopathologic results in children diagnosed with eosinophilic esophagitis. This is a retrospective review of the medical records for 38 children with histologic diagnosis of eosinophilic esophagitis performed at King Hussein Medical Center, during the period between January 2001 to February 2011, with the cut off biopsy diagnosis >/=20/HPF eosinophilic infiltrate. Patients were excluded if gastric or duodenal biopsies showed prominent eosinophilic infiltrate. Patients medical records were reviewed regarding age at presentation, gender, clinical presentation, associated disease. Laboratory, endoscopic and histologic results were also reviewed. A total 38 patients with histological diagnosis of eosinophilic esophagitis were included in this study. Thirty-one [82%] were males and 7 [18%] were females. Their ages ranged between 2-14 years. Mean age 8 years. The most commonly clinical presentation of eosinophilic esophagitis was vomiting which occurred among 26 children [68%], however, rash was presented in only one child [2%]. Peripheral eosinophilia >[0.5x10/L] was found in 45%. High serum IgE level [>100 IU/ml] was found in 39%. Positive radio allergo sorbent testing in 39%. The most frequent endoscopic findings were loss of normal vascularity found in 19 [50%] children, however, white exudates were found in 2[5%] children. Mean eosinophil count was 70 [20-120], eosinophilic degranulation, and bazal zone hyperplasia reported in 18 children [47%]. Eosinophilic esophagitis in Jordan displays similar clinical, endoscopic and pathologic features to those described in other countries. Endoscopic and histologic feature remain the gold standard for diagnosis of eosinophilic esophagitis