Eosinophilic oesophagitis and coeliac disease: is it just a casual association?
- 1Department of Paediatrics, Institute of Child Health IRCSS Burlo Garofolo, University of Trieste, Trieste, Italy
- 2Surgical and Endoscopic Digestive Unit, Ospedale Pediatrico Bambino Gesù, Rome, Italy
- 3Department of Paediatrics, Institute of Child Health IRCSS Burlo Garofolo, University of Trieste, Trieste, Italy
- Correspondence to:
Dr J Bua
Department of Paediatrics, Institute of Child Health, IRCSS Burlo Garofolo, Via dell’Istria 65/1, 34100 Trieste, Italy;
Eosinophilic oesophagitis (EO) is the leading cause of dysphagia in children.1 Long underestimated in the past, it is today being reported with increasing frequency. Acute and chronic dysphagia and food impaction are the typical symptoms in both children and young adults, whereas vomiting and refusal of food may be more frequent in infants.1,2 Diagnosis of EE is mainly based on the eosinophilic infiltration of the oesophageal mucosa (>20 eosinophils/high power field (HPF)) in association with some classic endoscopic features (adherent whitish plaques, oesophageal concentric rings, linear furrowing). The aetiology of EE is far from clear, but in about half of the cases reported it is associated with an allergy either to food or to aeroallergens.1,3
We describe three cases of EE, that we diagnosed by chance when performing endoscopy for the duodenal biopsy to confirm coeliac disease (CD). One case was diagnosed at the Institute of Child Health, IRCSS Burlo Garofolo, Trieste Italy, and, two at the Surgical and Endoscopic Digestive Unit of Ospedale Pediatrico Bambino Gesù, Rome, Italy.
A 7-year-old boy was referred to the Gastroenterology Department, IRCSS Burlo Garofolo, Trieste, Italy with persistent sideropaenic anaemia since the age of 4-years. Given the unresponsiveness of his anaemia to iron supplementation, CD was suspected and confirmed by the positivity of antiendomysial serum antibodies (EMAs) and antitransglutaminase antibodies (tTG immunoglobulin (Ig) A 213 IU). The boy was allergic to dust mite, cat epithelium and betullaceae. His most common allergic manifestations included rhinitis and asthma. He was referred to our institute to confirm the diagnosis of CD. …