Eosinophilic esophagitis (EoE) is a clinicopathologic disease characterised by esophageal dysfunction and eosinophil-predominant inflammation. Diagnosing EoE in children is particularly challenging as they tend to present with nonspecific symptoms and their mucosal specimens may have less than the threshold number of eosinophils. Reluctance to subject children to multiple endoscopic procedures and anesthesia often results in treatment with a proton pump inhibitor (PPI) first to evaluate clinical response. This approach presents a problem as a diagnosis of EoE may be missed. Here we present a case of a child with severe EoE whose initial biopsy did not show esophageal eosinophilia but progressed on to advance dis ease despite clinical response to PPI therapy.
Anesthesia ; Biopsy ; Child ; Diagnosis ; Eosinophilia ; Eosinophilic Esophagitis ; Eosinophils ; Food Hypersensitivity ; Humans ; Inflammation ; Proton Pump Inhibitors ; Proton Pumps

BACKGROUND: Although it is known that children with food allergies are at risk of impaired growth, this has not been well studied in South-East Asia. OBJECTIVE: The aim of this cross-sectional study is to survey the growth of children with food allergies in Singapore and the factors impacting it. METHODS: Anthropometric data, demographic data, type of food allergy, foods eliminated, and atopic comorbidities were recorded. Malnutrition was defined using World Health Organization standards (≤-2 z-score for weight-for-height [WH], weight-for-age [WA], and height-for-age [HA]).
Asia ; Child ; Comorbidity ; Cross-Sectional Studies ; Data Collection ; Diagnosis ; Eczema ; Food Hypersensitivity ; Growth Disorders ; Humans ; Hypersensitivity ; Immunoglobulin E ; Malnutrition ; Nutritionists ; Overweight ; Singapore ; Skin ; Thinness ; World Health Organization