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[Eosinophilic esophagitis in 29 pediatric patients]. / Esofagite eosinofílica em 29 pacientes pediátricos.
Ferreira, Cristina Targa; Vieira, Mário C; Vieira, Sandra Maria Gonçalves; Silva, Giovana Stival da; Yamamoto, Danielle Reis; Silveira, Themis Reverbel da.
Afiliação
  • Ferreira CT; Instituto do Aparelho Digestivo, Porto Alegre, RS. cristinatarga@terra.com.br
Arq Gastroenterol ; 45(2): 141-6, 2008.
Article em Pt | MEDLINE | ID: mdl-18622469
BACKGROUND: Eosinophilic esophagitis is a recently described entity with esophageal symptoms like gastroesophageal reflux disease and significant esophageal eosinophilic infiltration. AIM: To present our clinical series of 29 children with eosinophilic esophagitis, describing the clinical and diagnostic features, treatment and outcome. METHODS: We describe 29 patients (22 boys), 1-18 years-old, with 20 eosinophils per high-power field in esophageal biopsy specimens and absence of eosinophilic inflammation in the stomach and duodenum. Evaluation of the clinical, endoscopic and histologic findings, treatment and outcome was undertaken. RESULTS: The most common presenting symptoms included vomiting in 15 patients (52%) and abdominal pain in 11 patients (38%). Children under the age of 4 years presented with feeding disorder and failure to thrive. Patients between 5 and 8 years of age presented commonly with abdominal pain or symptoms that may be associated with reflux (heartburn and/or vomiting). Patients over the age of 8 presented most often with abdominal pain, dysphagia and occasional food impaction. Endoscopic features included vertical furrowing in 14 patients (48%), whitish papules in 12 (41%), corrugated rings in 2 patients (7%) and esophageal erosions in 3 patients (10%). In seven patients endoscopy was normal (24%). Treatment included swallowed fluticasone propionate in 19 patients and restriction diet in 7 patients. Patients who returned for follow-up had either improvement or remission of symptoms. After treatment, endoscopic biopsies were repeated in 11 patients, and a significant decrease in esophageal eosinophil counts was observed. CONCLUSIONS: The diagnosis of eosinophilic esophagitis must be considered when symptoms of reflux do not respond to conventional treatment. Upper gastrointestinal endoscopy must be complemented by a detailed analysis of histologic findings and eosinophil counts.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Eosinofilia / Esofagite Tipo de estudo: Clinical_trials / Diagnostic_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: Pt Ano de publicação: 2008 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Eosinofilia / Esofagite Tipo de estudo: Clinical_trials / Diagnostic_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: Pt Ano de publicação: 2008 Tipo de documento: Article