Advanced Practice Provider EoE Program (Live/Virtual) | November 2024-Adolescent Case Studies and Debates

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The document reviews pediatric Eosinophilic Esophagitis (EoE), focusing on clinical presentation, case studies, and management approaches. EoE, a chronic immune-mediated disease, predominantly affects males, with symptoms varying by age. Younger children show nonspecific symptoms like feeding disorders and vomiting, whereas older children and adolescents commonly experience dysphagia and food impaction. A family history of asthma, eczema, and food allergies is also prevalent in affected individuals.<br /><br />Diagnosis relies on endoscopic examination and histologic criteria, such as an eosinophil count of ≥15 eos/hpf. Additional tools for diagnosis may include allergy and pH impedance testing.<br /><br />Three case studies illustrate the complexity of EoE:<br /><br />1. A 10-year-old male with weight loss and abdominal pain, originally diagnosed with avoidant restrictive food intake disorder (ARFID), was found to have EoE. Treatment with swallowed budesonide resulted in symptom improvement and weight gain.<br />   <br />2. A 16-year-old male experienced vomiting and abdominal pain, initially suspected of being allergic reactions. His symptoms were identified as EoE, and after treatment with budesonide, he was able to resume a normal diet. His case underscores the importance of considering esophageal hypersensitivity and compliance checks in managing EoE.<br /><br />3. A 17-year-old female presented with dysphagia and heartburn. Despite initial treatment with dupilumab, symptoms persisted due to undiagnosed GERD. Treatment adjustments led to symptomatic and histological improvements.<br /><br />The document emphasizes that EoE requires tailored management strategies, often involving both dietary and pharmacological interventions. The overlap of symptoms between EoE and GERD complicates diagnosis and treatment, necessitating careful monitoring and follow-up. Current treatments, such as biologics like dupilumab, show promise for reducing inflammation and associated symptoms in EoE.

Asset Subtitle

Puanani E. Hopson, MS, DO

Keywords

Eosinophilic Esophagitis

pediatric EoE

clinical presentation

case studies

management approaches

endoscopic examination

histologic criteria

dietary interventions

pharmacological treatments

biologics