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Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
Upper Gastrointestinal Bleeding as the First Presentation of Eosinophilic Gastrointestinal Disease
Elif Ozdogan1, Latife Doganay Caglayan2, Ozlem Mizikoglu3
1From the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Koc University School of Medicine, Istanbul, Turkey.
Insights
Eosinophilic gastrointestinal disorders (EGIDs) can cause rare but severe gastrointestinal bleeding in children. Prompt diagnosis and early treatment, including dietary changes, lead to favorable outcomes.
Area of Science:
- Pediatric Gastroenterology
- Allergy and Immunology
- Gastroenterology
Background:
- Gastrointestinal bleeding is a rare but serious complication of eosinophilic gastrointestinal disorders (EGIDs).
- EGIDs are characterized by eosinophilic infiltration of the gastrointestinal tract, often associated with allergic conditions.
Purpose of the Study:
- To describe a case series of pediatric patients presenting with hematemesis due to EGID.
- To review the literature for similar cases and emphasize the importance of early diagnosis and treatment.
Main Methods:
- Retrospective case series of 5 pediatric patients (7-12 years) with hematemesis and diagnosed EGID.
- Review of 26 additional cases from existing literature.
Main Results:
- All patients presented with hematemesis; common findings included allergic history, peripheral eosinophilia, and elevated total IgE.
- Despite severe initial presentation, patients showed a favorable response to medical and dietary therapies.
- Literature review supported the findings and the efficacy of early intervention.
Conclusions:
- EGID should be considered in pediatric patients with unexplained hematemesis, especially those with allergic histories.
- Early recognition and prompt initiation of dietary and immunomodulating therapies are crucial for managing EGID-related gastrointestinal bleeding.
Abstract:
Gastrointestinal bleeding is a rare but potentially life-threatening manifestation of eosinophilic gastrointestinal disorders (EGIDs). Here, we describe a case series comprising 5 pediatric patients between 7 and 12 years of age, who presented to the emergency department with hematemesis and were subsequently diagnosed with EGID. Accompanying allergic history, peripheral eosinophilia, and total IgE elevation were common. Despite a more severe presentation, response to medical and dietary therapy was favorable. A comprehensive review of the literature revealed 26 other cases with similar findings that reinforced the importance of prompt recognition and early dietary and immunomodulating therapy in the control of this disease.
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