Obstructive Vasculopathy in Eosinophilic Esophagitis

Introduction: Eosinophilic esophagitis (EOE) is a growing problem in recent years especially in pediatric age group. The latest pathologic criterion for EOE is the presence of more than 15 eosinophils per high power field (HPF). Some investigators have suggested grading and scoring schemes including other criteria such as fibrosis of laminapropria for better classification of patients, however no mention about vascular changes in lamina propria was found after thorough search of literature. Hereby we wanted to report a case of eosinophilic esophagitis with obstructive vasculopathy for the first time. Report of Case: A two year old boy referred to our center with history of respiratory problems started in six months of age. He is under treatment with diagnosis of asthma since one year of age. Parents complained about episodes of vomiting following cough since then. No specific workup and treatment for gastro-intestinal symptoms was performed till now. Esophageal biopsy showed eosinophilic esophagitis. Laminapropria showed large vessels with marked thickening of media, resulting in obstruction of luminea. There was no significant inflammatory infiltrate in the wall of vessels.Discussion: Eosinophilic esophagitis can result in fibrosis of lamina propria which may lead to stenosis and peristaltic defects in esophagus. Vascular changes in lamina propria are not reported as yet, however obstructive vasculopathy was seen in our case which may worsen the condition.

کلیدواژه ها:

Esophagitis ، Eosinophilic ، Vessel ، Obstructive Vasculopathy