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Paediatric eosinophilic oesophagitis presenting to the otolaryngologist

Published online by Cambridge University Press:  30 July 2009

R Harris ,
S Mitton ,
S Chong  and
H Daya
R Harris*
Affiliation:
Department of Otolaryngology, St George's Hospital, London, UK
S Mitton
Affiliation:
Department of Paediatric Gastroenterology, St George's Hospital, London, UK
S Chong
Affiliation:
Department of Paediatric Gastroenterology, St Helier Hospital, Sutton, Middlesex, UK
H Daya
Affiliation:
Department of Otolaryngology, St George's Hospital, London, UK
*
Address for correspondence: Mr R L Harris, Department of Otolaryngology, St George's Hospital, Blackshaw Road, London SW17 OQT, UK. Fax: 0207 829 8644 E-mail: bertieharris@yahoo.com
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Abstract

Introduction:

The prevalence of eosinophilic oesophagitis is increasing. A Pubmed search for ‘eosinophilic oesophagitis’ and ‘eosinophilic esophagitis’ yielded 345 publications since 1976. Only seven were in otolaryngology journals.1–7 Patients typically present with dysphagia, vomiting, dyspepsia or food impaction and are therefore usually referred to a paediatric gastroenterologist; otolaryngologists are not usually involved in management. A missed diagnosis may result in oesophageal stricture.

Methods:

Two patients, aged two and four years, were referred to the paediatric otolaryngology department with intermittent upper oesophageal food impaction. A paediatric gastroenterologist was involved in the investigation. Histological examination of oesophageal biopsies demonstrated changes consistent with eosinophilic oesophagitis.

Results:

Both patients were expediently diagnosed, investigated and managed.

Conclusion:

A diagnosis of eosinophilic oesophagitis must be considered in patients presenting with food bolus impaction. Early involvement of a paediatric gastroenterology team in the diagnosis is recommended in children presenting with oesophageal symptoms, in order to avoid delayed diagnosis.

Keywords

Eosinophilic OesophagitisDysphagia
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 1 , January 2010 , pp. 96 - 100
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented at the International Conference of the European Society of Pediatric Otorhinolaryngology, 8–11th June 2008, Budapest, Hungary.

References

1 Potter, JW, Saeian, K, Staff, D, Massey, BT, Komorowski, RA, Shaker, R et al. Eosinophilic esophagitis in adults: an emerging problem with unique esophageal features. Gastrointest Endosc 2004;59:355–61CrossRefGoogle ScholarPubMed
2 Fox, VL, Nurko, S, Furuta, GT. Eosinophilic esophagitis: it's not just kid's stuff. Gastrointest Endosc 2002;56:260–70CrossRefGoogle Scholar
3 Noel, R, Putnam, PE, Rothenberg, ME. Eosinophilic esophagitis. N Engl J Med 2004;351:940–1CrossRefGoogle ScholarPubMed
4 Dauer, EH, Ponikau, JU, Smyrk, TC, Murray, JA, Thompson, DM. Airway manifestations of pediatric eosinophilic esophagitis: a clinical and histopathologic report of an emerging association. Ann Otol Rhinol Laryngol 2006;115:507–17CrossRefGoogle ScholarPubMed
5 Noel, RJ, Tipnis, NA. Eosinophilic esophagitis – a mimic of GERD. Int J Pediatr Otorhinolaryngol 2006;70:1147–53CrossRefGoogle ScholarPubMed
6 Thompson, DM, Arora, AS, Romero, Y, Dauer, EH. Eosinophilic esophagitis: its role in aerodigestive tract disorders. Otolaryngol Clin North Am 2006;39:205–21CrossRefGoogle ScholarPubMed
7 Gupta, SP, Kirse, DJ, Postma, GN, Belafsky, PC. Eosinophilic esophagitis. Ear Nose Throat J 2005;84:632–3CrossRefGoogle ScholarPubMed
8 Dauer, EH, Freese, DK, El-Youssef, M, Thompson, DM. Clinical characteristics of eosinophilic esophagitis in children. Ann Otol Rhinol Laryngol 2005;114:827–33CrossRefGoogle ScholarPubMed
9 Miller, CK, Willging, JP. Advances in the evaluation and management of pediatric dysphagia. Curr Opin Otolaryngol Head Neck Surg 2003;11:442–6CrossRefGoogle ScholarPubMed
10 Goldstein, NA, Putnam, PE, Dohar, JE. Laryngeal cleft and eosinophilic gastroenteritis: report of 2 cases. Arch Otolaryngol Head Neck Surg 2000;126:227–30CrossRefGoogle Scholar
11 Liacouras, C, Ruchelli, E. Eosinophilic esophagitis. Curr Opin Pediatr 2004;16:560–6CrossRefGoogle ScholarPubMed
12 Kelly, KJ, Lazenby, AJ, Rowe, PC, Yardley, JHY, Perman, JA, Sampson, HA. Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with an aminoacid-based formula. Gastroenterol 1995;109:1503–12CrossRefGoogle Scholar
13 Liacouras, CA. Failed Nissen fundoplication in two patients who had persistent vomiting and eosinophilic esophagitis. J Pediatr Gastroenterol Nutr 1997;32:1504–6Google ScholarPubMed
14 Walsh, SV, Antonioli, DA, Goldman, H, Fox, VL, Bousvaros, A, Leichtner, AM et al. Allergic esophagitis in children; a clinicopathologic entity. Am J Surg Pathol 1999;23:390–6CrossRefGoogle Scholar
15 Orenstein, SR, Shalaby, TM, Di Lorenzo, C, Putnam, PE, Sigurdsson, L, Kocochis, S. The spectrum of eosinophilic esophagitis beyond infancy: a clinical series of 30 children. Am J Gastrointest 2000;95:1422–30CrossRefGoogle ScholarPubMed
16 Liacouras, C, Wenner, W, Brown, K, Ruchelli, E. Primary eosinophilic esophagitis in children: successful treatment with oral corticosteroids. J Pediatr Gastroenterol Nutr 1998;26:380–5Google ScholarPubMed
17 Teitelbaum, JE, Fox, VL, Twarog, FJ, Nurko, S, Antonioli, D, Gleich, G et al. Eosinophilic esophagitis in children: immunopathological analysis and response to fluticasone propionate. Gastroenterology 2002;122:1216–25CrossRefGoogle ScholarPubMed
18 Stevoff, C, Rao, S, Parsons, W, Kharilas, P, Hirano, I. EUS and histopathologic correlates in eosinophilic esophagitis. Gastrointest Endosc 2001;54:373–7CrossRefGoogle ScholarPubMed
19 Chang, F, Anderson, S. Clinical and pathological features of eosinophilic oesophagitis: a review. Pathology 2008;40:3–8CrossRefGoogle ScholarPubMed
20 Straumann, A, Spichtin, H, Bucher, KA, Herr, P, Simon, H. Eosinophilic esophagitis: red on microscopy, white on endoscopy. Digestion 2004;70:109–16CrossRefGoogle ScholarPubMed
21 Esposito, S, Marinello, D, Paracchini, R, Guidali, P, Oderda, G. Long-term follow-up of symptoms and peripheral eosinophil counts in seven children with eosinophilic esophagitis. J Pediatr Gastroenterol Nutr 2004;38:452–6Google ScholarPubMed
22 Sundaram, S, Sunku, B, Nelson, SP, Sentongo, T, Melin-Aldana, H, Kumar, R et al. Adherent white plaques: an endoscopic finding in eosinophilic esophagitis. J Pediatr Gastroenterol Nutr 2004;38:208–12Google ScholarPubMed
23 Spergel, JM, Beausoleil, JL, Mascarenhas, M, Liacouras, CA. The use of skin prick test and patch tests to identify causative foods in allergic esophagitis. J Allergy Clin Immunol 2002;109:363–8CrossRefGoogle Scholar
24 Croese, J, Fairley, SK, Masson, JW, Chong, AK, Whitaker, DA, Kanowski, PA et al. Clinical and endoscopic features of eosinophilic esophagitis in adults. Gastrointest Endosc 2003;58:516–22CrossRefGoogle ScholarPubMed
25 Noel, RJ, Putnam, PE, Collins, MH, Assa'ad, AH, Guajardo, JR, Jameson, SC et al. Clinical and immunopathologic effects of swallowed fluticasone for eosinophilic esophagitis. Clin Gastroenterol Hepatol 2004;2:568–75CrossRefGoogle ScholarPubMed
26 Arora, AS, Perrault, J, Smyrk, TC. Topical corticosteroid treatment of dysphagia due to eosinophilic esophagitis in adults. Mayo Clin Proc 2003;78:830–5CrossRefGoogle ScholarPubMed