Email this article A rare combination of complicated eosinophilic esophagitis and Crohn's disease in a 17-year-old child. Case report
- Authors: Merkulova A.O.1, Kharitonova A.Y.1, Shavrov A.A.1,2, Shavrov A.A.3, Karaseva O.V.1,4, Kapustin V.A.1
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Affiliations:
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma
- Pirogov Russian National Research Medical University
- Sechenov First Moscow State Medical University (Sechenov University)
- National Medical Research Center for Children's Health
- Issue: No 4 (2024)
- Pages: 416-420
- Section: Articles
- URL: https://pediatria.orscience.ru/2658-6630/article/view/630050
- DOI: https://doi.org/10.26442/26586630.2024.4.202900
- ID: 630050
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Abstract
Eosinophilic esophagitis (EoE) and inflammatory bowel disease (IBD) are chronic immune-mediated diseases with complex pathogenesis. Little is known about overlap of EoE and IBD in pediatrics.A 17-year-old male patient was admitted to the endoscopy department of the Research Institute of Emergency Pediatric Surgery and Trauma (Moscow) with dysphagia that had been lasting for a year. For the first time EoE was diagnosed and histologically confirmed in this child 2 years ago. Since that time the patient didn’t receive any treatment and follow-up. Endoscopy confirmed eosinophilic esophagitis with esophageal stricture (E2R1E1F2S1) which was successfully corrected by the endoscopic balloon dilatation. The symptoms of dysphagia disappeared completely, but 3 months later the patient complained of blood in the stool and an anal fissure. Esophagogastroduodenoscopy revealed decreased activity of EoE (E1R0E1F1S0) without strictures. Crohn's disease was diagnosed by ileocolonoscopy with biopsy. An anal fissure was epithelized within treatment of Crohn's disease. Comorbid complicated forms of eosinophilic esophagitis and Crohn's disease in children are uncommon. Endoscopy allowed timely minimally invasive treatment of esophageal stricture as well as diagnostics of a rare combination of immune-mediated chronic diseases of digestive tract.
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About the authors
Anastasia O. Merkulova
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma
Author for correspondence.
Email: anast.merkulova@gmail.com
ORCID iD: 0000-0001-8623-0947
SPIN-code: 2535-1504
endoscopist
Russian Federation, MoscowAnastasia Yu. Kharitonova
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma
Email: anast.merkulova@gmail.com
ORCID iD: 0000-0001-6218-3605
SPIN-code: 1251-5150
Cand. Sci. (Med.)
Russian Federation, MoscowAndrey A. Shavrov
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma; Pirogov Russian National Research Medical University
Email: anast.merkulova@gmail.com
ORCID iD: 0000-0003-3666-2674
SPIN-code: 3455-9611
D. Sci. (Med.), Prof.
Russian Federation, Moscow; MoscowAnton A. Shavrov
Sechenov First Moscow State Medical University (Sechenov University)
Email: anast.merkulova@gmail.com
ORCID iD: 0000-0002-0178-2265
SPIN-code: 2381-3024
Cand. Sci. (Med.)
Russian Federation, MoscowOlga V. Karaseva
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma; National Medical Research Center for Children's Health
Email: anast.merkulova@gmail.com
ORCID iD: 0000-0001-9418-4418
SPIN-code: 7894-8369
D. Sci. (Med.)
Russian Federation, Moscow; MoscowVitalii A. Kapustin
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma
Email: anast.merkulova@gmail.com
ORCID iD: 0000-0002-3407-6535
SPIN-code: 7282-4527
pediatric surgeon
Russian Federation, MoscowReferences
- Górriz GC, Matallana RV, Álvarez MÓ, et al. Eosinophilic esophagitis: an underdiagnosed cause of dysphagia and food impaction to be recognized by otolaryngologists. HNO. 2018;66(7):534-42.
- Ивашкин В.Т., Баранская Е.К., Кайбышева В.О., и др. Клинические рекомендации по диагностике и лечению эозинофильного эзофагита. М., 2013 [Ivashkin VT, Baranskaia EK, Kaybysheva VO, et al. Klinicheskiie rekomendatsii po diagnostike i lecheniiu eozinofilnogo ezofagita. Moscow, 2013 (in Russian)].
- Lucendo AJ, Molina-Infante J, Arias Á, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J. 2017;5(3):335-58. doi: 10.1177/2050640616689525
- Sheehan D, Shanahan F. The Gut Microbiota in Inflammatory Bowel Disease. Gastroenterol Clin North Am. 2017;46(1):143-54. doi: 10.1016/j.gtc.2016.09.011
- Rothenberg ME. Molecular, genetic, and cellular bases for treating eosinophilic esophagitis. Gastroenterology. 2015;148:1143-57.
- Strober W, Fuss IJ. Proinflammatory cytokines in the pathogenesis of inflammatory bowel diseases. Gastroenterology. 2011;140:1756-67.
- Dellon ES, Hirano I. Epidemiology and Natural History of Eosinophilic Esophagitis. Gastroenterology. 2018;154:319-32.e3.
- Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012;142:46-54.
- Aloi M, D’Arcangelo G, Rossetti D, et al. Occurrence and Clinical Impact of Eosinophilic Esophagitis in a Large Cohort of Children With Inflammatory Bowel Disease. Inflamm Bowel Dis. 2023;29(7):1057-64. doi: 10.1093/ibd/izac172. Erratum in: Inflamm Bowel Dis. 2023;29(1):183.
- Moore H, Wechsler J, Frost C, et al. Comorbid Diagnosis of Eosinophilic Esophagitis and Inflammatory Bowel Disease in the Pediatric Population. J Pediatr Gastroenterol Nutr. 2021;72(3):398-403. doi: 10.1097/MPG.0000000000003002
- Харитонова А.Ю., Карасева О.В., Шавров А.А., Капустин В.А. Эндоскопическая диагностика и лечение стенозов пищевода у детей. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2020;(10):184 [Kharitonova AIu, Karaseva OV, Shavrov AA, Kapustin VA. Endoskopicheskaia diagnostika i lecheniie stenozov pishchevoda u detei. Rossiiskii vestnik detskoi khirurgii, anesteziologii i reanimatologii. 2020;(10):184 (in Russian)].
- Schoepfer AM, Gonsalves N, Bussmann C, et al. Esophageal dilation in eosinophilic esophagitis: effectiveness, safety, and impact on the underlying inflammation. Am J Gastroenterol. 2010;105:1062-70.
- Menard-Katcher C, Furuta GT, Kramer RE. Dilation of Pediatric Eosinophilic Esophagitis: Adverse Events and Short-term Outcomes. J Pediatr Gastroenterol Nutr. 2017;64(5):701-6. doi: 10.1097/MPG.0000000000001336
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