Eosinophilic gastrointestinal disorder in an infant with feeding dysfunction

Area of Science:

• Pediatric Gastroenterology
• Immunology
• Allergy

Background:

• Feeding dysfunction (FD) is a common symptom in pediatric eosinophilic gastrointestinal disorders (EGIDs).
• EGIDs are increasingly recognized as a cause of gastrointestinal symptoms in young children.
• Differentiating between various EGIDs can be challenging.

Purpose of the Study:

• To report a case of an infant with an EGID presenting with feeding dysfunction.
• To emphasize the importance of considering a broad range of EGIDs in the differential diagnosis of pediatric feeding difficulties.
• To illustrate the diagnostic workup and management of such a case.

Main Methods:

• Case report of an 8-month-old female infant with vomiting, poor weight gain, and feeding difficulties.
• Diagnostic investigations included barium swallow, upper gastrointestinal contrast radiography, gastrointestinal scintigraphy, and endoscopy with biopsies.
• Treatment involved an elemental diet.

Main Results:

• Diagnostic tests revealed tracheal aspiration, reduced esophageal clearance, and delayed gastric emptying.
• Endoscopic biopsies showed esophagitis and duodenitis with eosinophilic inflammation.
• Elemental diet administration led to weight gain and improved esophageal and gastric clearance, though vomiting and FD partially persisted.

Conclusions:

• Feeding dysfunction in infants warrants a comprehensive evaluation for various eosinophilic gastrointestinal disorders.
• Eosinophilic esophagitis should be considered, but other EGIDs must also be included in the differential diagnosis.
• Early recognition and appropriate dietary management can improve outcomes in infants with EGIDs and feeding dysfunction.