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Loh W, Wright KM, Chiou FK. Absence of esophageal eosinophilia in a toddler with severe eosinophilic esophagitis. Asia Pac Allergy. 2017;7(4):243-246doi: 10.5415/apallergy.2017.7.4.243.
Loh, W., Wright, K. M., & Chiou, F. K. (2017). Absence of esophageal eosinophilia in a toddler with severe eosinophilic esophagitis. Asia Pacific allergy, 7(4), 243-246. https://doi.org/10.5415/apallergy.2017.7.4.243
Loh, Wenyin, et al. "Absence of esophageal eosinophilia in a toddler with severe eosinophilic esophagitis." Asia Pacific allergy vol. 7,4 (2017): 243-246. doi: https://doi.org/10.5415/apallergy.2017.7.4.243
Loh W, Wright KM, Chiou FK. Absence of esophageal eosinophilia in a toddler with severe eosinophilic esophagitis. Asia Pac Allergy. 2017 Oct;7(4):243-246. doi: 10.5415/apallergy.2017.7.4.243. Epub 2017 Oct 19. PMID: 29094023; PMCID: PMC5663753.
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Asia Pac Allergy. 2017 Oct;7(4):243-246. doi: 10.5415/apallergy.2017.7.4.243. Epub 2017 Oct 19.

Absence of esophageal eosinophilia in a toddler with severe eosinophilic esophagitis.

Asia Pacific allergy

Wenyin Loh, Karen Michelle Wright, Fang Kuan Chiou

Affiliations

  1. Department of Paediatric Medicine, Allergy Service, KK Women's and Children's Hospital, Singapore 229899.
  2. Department of Nutrition & Dietetics, KK Women's and Children's Hospital, Singapore 229899.
  3. Department of Paediatric Medicine, Gastroenterology Service, KK Women's and Children's Hospital, Singapore 229899.

PMID: 29094023 PMCID: PMC5663753 DOI: 10.5415/apallergy.2017.7.4.243

Abstract

Eosinophilic esophagitis (EoE) is a clinicopathologic disease characterised by esophageal dysfunction and eosinophil-predominant inflammation. Diagnosing EoE in children is particularly challenging as they tend to present with nonspecific symptoms and their mucosal specimens may have less than the threshold number of eosinophils. Reluctance to subject children to multiple endoscopic procedures and anesthesia often results in treatment with a proton pump inhibitor (PPI) first to evaluate clinical response. This approach presents a problem as a diagnosis of EoE may be missed. Here we present a case of a child with severe EoE whose initial biopsy did not show esophageal eosinophilia but progressed on to advance dis ease despite clinical response to PPI therapy.

Keywords: Child; Eosinophilia; Eosinophilic esophagitis; Food allergy; Proton pump inhibitors

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