Eosinophilic Esophagitis as a Rare Cause of Dysphagia: Two Case Presentation with Literature Review

Eosinophilic esophagitis (EO) is a chronic, immune mediated disease of esophagus characterized with esophageal dysfunction, retrosternal heartburn, and eosinophilpredominant inflammation. Most patients with EO clinically presents with dysphagia, reflux-like symptoms and swallowing difficulties. Although food allergens are mostly accused in the pathophysiology of EO, there is still unknown additional factors that are belived to be exist in the pathophysiology. Herein, we would like to present two patients who admitted to our clinic with the complaint of dysphagia and was diagnosed as EO. Oral fluticazone treatment was started with dietary restriction to both patients. A favorable outcome was achieved during follow-up.

Yutma Güçlüğünün Nadir Bir Nedeni Eozinofilik Özofajit: İki Olgu Sunumu ve Literatür Derlemesi

Eozinofilik özofajit (EÖ) özofagusun kronik, immün aracılı bir hastalığıdır ve genellikle özofageal disfonksiyon, retrosternal yanma, ve eozinofil baskın inflamasyon ile karakterizedir. EÖ’li birçok hasta çoğunlukla yutma güçlüğü, reflü benzeri şikayetler ve yutma güçlüğü ile prezente olur. Her ne kadar diyetsel alerjenler patofizyolojide çoğunlukla suçlansa da bilinmeyen birçok faktörün de patofizyolojiden sorumlu olduğuna inanılmaktadır. Biz bu vaka raporlarında kliniğimize yutma güçlüğü ile başvuran ve EÖ tanısı alan 2 hastayı sunmayı amaçladık. Tedavide oral flutikazon ve diyet kısıtlaması her iki hastaya da başlandı ve izlem sürecinde her iki hastada başarılı sonuçlar elde edildi.

Kaynakça

1. Dellon ES. Eosinophilic esophagitis. Gastroenterol Clin North Am. 2013;42:133-53.

2. Landres RT, Kuster GG, Strum WB. Eosinophilic esophagitis in a patient with vigorous achalasia. Gastroenterology 1978;74:1298-1301.

3. Altun R, Akbas E, Yıldırım AE, Öcal S, Korkmaz M, Selcuk H. Frequency of eosinophilic esophagitis in patients with esophageal symptoms: a single-center Turkish experience. Dis Esophagus 2013;26:776-81.

4. Moawad FJ, Veerappan GR, Wong RK. Eosinophilic esophagitis. Dig Dis Sci 2009;54:1818-28.

5. Liacouras CA, Spergel JM, Ruchelli E, et al. Eosinophilic esophagitis: a 10-year experience in 381 children. Clin Gastroenterol Hepatol. 2005;3:1198-206.

6. DeBrosse CW, Collins MH, Buckmeier Butz BK, et al. Identification, epidemiology, and chronicity of pediatric esophageal eosinophilia, 1982-1999. J Allergy Clin Immunol. 2010;126:112-9.

7. Akar HH, Sevinc E, Akgun H, Özcan SS, Arslan D, Tahan F. Eosinophilic esophagitis in a girl with pollen allergy who showed trachealization. Turk J Gastroenterol. 2015;26:69-70.

8. Destek S, Gul VO, Ahioglu S, Tatar Z, Erbil Y. A rare cause of chronic dysphagia: eosinophilic esophagitis. J Surg Case Rep. 2014;2014(9).

9. Spergel JM, Andrews T, Brown-Whitehorn TF, Beausoleil JL, Liacouras CA. Treatment of eosinophilic esophagitis with specific food elimination diet directed by a combination of skin prick and patch tests. Ann Allergy Asthma Immunol. 2005;95:336-43.

10. Liacouras CA, Spergel JM, Ruchelli E, Verma R, Mascarenhas M, Semeao E, Flick J, Kelly J, Brown-Whitehorn T, Mamula P, Markowitz JE. Eosinophilic esophagitis: a 10-year experience in 381 children. Clin Gastroenterol Hepatol. 2005;3:1198-206.

11. Ferguson DD, Foxx-Orenstein AE. Eosinophilic esophagitis: an update. Dis Esophagus. 2007;20:2-8.

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