Eosinophilic esophagitis in children: Experience in diagnosis, clinical observation in a multidisciplinary hospital

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This study presented the characteristics of seven patients with eosinophilic esophagitis from age 1 year and 2 months to age 17 years and 4 months. The follow-up duration ranged from 1 to 7.5 years.

Disease onset was observed at different ages: aged >2 years (n=6) and 2 months (n=1). The period between the occurrences of the first symptom to diagnosis ranged from 3 months to 9 years. In one patient, the symptoms were associated with cow’s milk allergy, whereas the cause was not identified in other cases. Allergic diseases (i.e., atopic dermatitis, allergic rhinitis, and asthma) were observed in six patients.

Treatment was provided according to the clinical guidelines. Six patients were prescribed topical steroids (budesonide) and an empirical elimination diet. One patient was prescribed only with an empirical elimination diet due to the steroid phobia of the parents. However, the ineffectiveness of the diet was the basis for topical steroid prescription. During the follow-up, a relapse was observed in two patients who required repeated treatments.

A clinical case of eosinophilic esophagitis in a 6-year-old child, with 7.5 years of follow-up, was described. According to the anamnesis, the patient visited a gastroenterologist 4 years after the onset of dysphagia symptoms. Endoscopy revealed cicatricial stenosis of the upper third of the esophagus (grades 2–3). A morphological study of the esophageal mucosa, which was performed after repeated endoscopic bougienage and a 5-month course of antisecretory therapy was deemed ineffective, revealed massive eosinophilic infiltration. Eosinophilic esophagitis was confirmed based on the anamnesis, clinical symptoms, and endoscopic and morphological data. An elimination diet and topical corticosteroids (budesonide) were prescribed. Following the treatment, the patient showed significant improvements. Subsequently, during the follow-up, a relapse of eosinophilic esophagitis was diagnosed twice (with an interval of 2.3 and 2.5 years), which required topical steroids (case 1) and proton pump inhibitors (case 2).

This paper highlights the importance of a multidisciplinary approach, involving an allergist-immunologist, pediatrician, gastroenterologist, endoscopist, and pathologist, in the management of eosinophilic esophagitis in children.

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About the authors

Rezeda F. Khakimova

Kazan State Medical University

Email: khakimova@yandex.ru
ORCID iD: 0000-0003-0754-9605
SPIN-code: 4782-2864

MD, Dr. Sci. (Med.), Professor

Russian Federation, Kazan

Aelita A. Kamalova

Kazan State Medical University; Republic Childrens Hospital

Email: aelitakamalova@gmail.com
ORCID iD: 0000-0002-2957-680X
SPIN-code: 3922-1391

MD, Dr. Sci. (Med.)

Russian Federation, Kazan; Kazan

Nikolay S. Polyakov

Republic Childrens Hospital

Email: drkbendo2017@gmail.com
ORCID iD: 0000-0001-7949-9091
SPIN-code: 9554-1257
Russian Federation, Kazan

Aleksandr E. Khomyakov

Republic Childrens Hospital

Email: drkb.khomyakov@gmail.com
ORCID iD: 0000-0002-5032-2599
SPIN-code: 1933-8444
Russian Federation, Kazan

Railya A. Nizamova

Republic Childrens Hospital

Author for correspondence.
Email: railya.nizamova@tatar.ru
ORCID iD: 0000-0002-7761-3046
SPIN-code: 5511-2941
Russian Federation, Kazan

Madina Sh. Zaynetdinova

Republic Childrens Hospital

Email: Madina.Zaynetdinova@tatar.ru
ORCID iD: 0000-0002-0767-541X
SPIN-code: 6944-7354
Russian Federation, Kazan

Lika D. Cheminava

Republic Childrens Hospital

Email: likacheminava@mail.ru
ORCID iD: 0000-0002-0896-6729
SPIN-code: 4745-1872
Russian Federation, Kazan


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  5. Khakimova RF, Fаtkullina RG, Anokhina SG, et al. Clinical case of eosinophilic esophagitis in a 6-year old child. Practical medicine. 2016;8(100):123–126. (In Russ).

Supplementary files

Supplementary Files
1. Fig. 1. Esophageal mucosa before treatment.

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2. Fig. 2. Esophageal mucosa 1 year after the end of therapy with topical glucocorticoid.

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