Mehmet AĞIN, Gökhan TÜMGÖR, Nilgün Uyduran ÜNAL, Serdar İSKİT, Figen DORAN

Yutma Güçlüğünün Sık Düşünülmeyen Tanısı; Eozinofilik Özofajit

Eozinofilik özofajit, özofagus mukozasının eozinofil lökositler ile infiltrasyonudur. Çocuklarda nadir görülür ve bulguları gastroözofageal reflü ile benzerdir. Yutma güçlüğü nedeni ile çocuk cerrahisinde özofagus balon dilatasyonu uygulanan ve eozinofilik özofajit olduğu saptanan bu olgu disfajili çocuğa yaklaşıma dikkat çekmek amacı ile sunulmuştur. Toplam IgE=834 IU/mL ve spesifik IgE - , Fx5 - negatif saptandı. Üst gastrointestinal sistem endoskopisinde özofagusun mukozasının soluk, yapısının sert, motilitesinin bozuk olduğu gözlendi ve birkaç adet milimetrik beyaz lezyonlar görüldü. Özofagus biyopsi materyallerinde mukozada eozinofil infiltrasyonun %60 oranında olduğu gözlendi. Olguya eozinofilik özofajit tanısı ile oral prednizolon 1 mg/kg/gün başlandı. Olgunun bir hafta sonraki poliklinik kontrolünde disfaji yakınmalarında belirgin düzelme olduğu ve birinci ay kontrolünde hiçbir yakınmasının olmadığı gözlendi. Disfaji ve reflü benzeri semptomlarda özellikle gastroözofageal reflü tedavisine yanıt alınamıyorsa eozinofilik özofajit tanısı mutlaka dikkate alınmalıdır

Anahtar Kelimeler:

Disfaji, eozinofilik, özofajit, gastroözefageal reflü, çocuk

A Non-Frequently Considered Diagnosis of Dysphagia; Eosinophilic Esophagitis

Eosinophilic Esophagitis is infiltration of esophagus mucosa by eosinophil leucocyte. It is rarely observed in children and the symptoms are similar to gastroesophageal reflux. This case, which was applied esophagus balloon dilatation in the pediatric surgery due to dysphagia and diagnosed eosinophilic esophagitis, was presented in order to attract attention to the approach to the child with dysphagia. Total IgE=834 IU/mL and specific IgE - , Fx5 - was found negative. In the upper GIS endoscopy, it was observed that esophagus mucosa was pale, its structure was hard and its motility was disordered and a couple milimetric white lesions were observed as well. In the esophagus biopsy materials, it was observed that the eosinophil infiltration in the mucosa was 60%. With the diagnosis of Eosinophilic Esophagitis, the case was started on oral prednisolone 1 mg/kg/day. In the polyclinic control of the case after a week, it was observed that there was a significant decrease in the complaints about dysphagia and in the one-month control the complaints were all gone. In the symptoms similar to dysphagia and reflux, especially if the case is not responding to gastroesophageal reflux treatment, the diagnosis of Eosinophilic Esophagitis should absolutely be considered

Keywords:

Dysphagia, eosinophilic, esophagitis, gastroesophageal reflux, child,

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