Incidence and diagnostic features of eosinophilic esophagitis in a group of children with dysphagia and gastroesophageal reflux disease

ABSTRACT

To investigate the incidence and diagnostic features of eosinophilic esophagitis [EoE] in a group of children with dysphagia and gastroesophageal reflux disease. This study was designed as a retrospective case analysis of 229 patients who underwent upper gastrointestinal endoscopy between January 2009 and January 2012 at a private tertiary care hospital in Riyadh, Saudi Arabia to ascertain the proportion of patients with eosinophilic esophagitis. Out of 229 children, 14 children were diagnosed as EoE [esophageal eosinophil count more than 15/high power field on esophageal biopsies], but 3 children were excluded because of other associated conditions. There were 8 males and 3 females with a mean age of 8.4 years [<18 years]. The major presentation was dysphagia followed by vomiting and epigastric pain. History of allergy and bronchial asthma was present in 40-50% of children. Peripheral eosinophilia was present in 36.3% [range 7-28%]. Barium contrast was abnormal in 3 children. Typical ringed [circular] appearance of esophagus was found in 3, linear furrowing in 2, and moderate to severe esophagitis in 8 children. All the patients were managed with swallowed inhaled steroids, except 2 patients who were initially given systemic steroids. Eosinophilic esophagitis is not an uncommon manifestation in children with dysphagia, and should be considered as one of the top differential diagnoses in patients with reflux esophagitis