Eosinophilic infiltration of the esophagus: Gastroesophageal reflux versus eosinophilic esophagitis in children - Discussion on daily practice

Eosinophilic infiltration of the esophagus: Gastroesophageal reflux versus eosinophilic esophagitis in children - Discussion on daily practice

Author Cury, Edson Khodor Autor UNIFESP Google Scholar
Schraibman, V Google Scholar
Faintuch, S. Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background/Purpose: Children presenting with persistent symptoms attributed to gastroesophaeal reflux disease (GERD) that are unresponsive to both medical and surgical therapies are commonly submitted to esophageal biopsies, the results of which show an abnormal presence of eosinophils. in this setting, eosinophilic esophagitis may be the correct diagnosis. the purpose of this report is to clarify the importance of esophageal eosinophilic infiltration, regardless of whether associated with acid reflux, ie, as an independent symptomatic entity, when treating a patient with refractory GERD.Methods: Two boys, aged 8 and 7 years, had the classic symptoms of GERD. They were treated with antacid without improvement of the esophagic lesions. Subsequent esophageal biopsy results showed marked eosinophilic infiltration. From this moment on, eosinophilic esophagitis started to be considered the main diagnosis.Results: Although eosinophilic infiltration caused by GERD is very frequently found in esophageal biopsy, in case of refractory drug treatment and microscopic findings of a great number of eosinophils and mast cells, eosinophilic esophagitis must be considered. This disease is better treated with corticoids instead of antacid drugs. It explains the reason some patients do not respond to antacid and surgical treatment and remain symptomatic with esophagic lesions.Conclusions: in refractory cases of GERD, eosinophilic esophagitis must be considered before any surgical measure.
Keywords eosinoplhilic esophagitis
gastroeophageal reflux
esophagitis
Language English
Date 2004-02-01
Published in Journal of Pediatric Surgery. Philadelphia: W B Saunders Co, v. 39, n. 2, 4 p., 2004.
ISSN 0022-3468 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co
Extent 4
Origin http://dx.doi.org/10.1016/j.jpedsurg.2003.10.028
Access rights Closed access
Type Article
Web of Science ID WOS:000189239000053
URI http://repositorio.unifesp.br/handle/11600/27607

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