Clinical Presentation and Nutrition Management of Pediatric Eosinophilic Esophagitis

J.A., an 18-month old male, presented to UNC Pediatric GI Clinic with acute febrile illness. During his illness, J.A loss significant weight and became generally disinterested in eating. His parents reported that J.A. began to pat his chest and whine and occasionally would throw up after eating a few bites of food. J.A. was initially diagnosed with hypoalbuminemia, failure to thrive (FTT), and feeding difficulties. His severe illness resulted in hospitalization and thorough testing to determine the source of his symptoms. Endoscopy during hospital admission demonstrated findings consistent with severe esophageal eosinophilia. He was diagnosed with Eosinophilic Esophagitis (EoE) and protein losing enteropathy with a likely secondary immunodeficiency. This case study serves to increase awareness of EoE, a newly appreciated disorder in an area of research that is only recently developing and is continuing to grow. We will define EoE, its etiology, symptoms, and diagnostic criteria. We will discuss the nutrition implications and therapy options in children with EoE. J.A., who matched classical presentation and achieved good control of his disease after closely following treatment guidelines, will serve as a model case of EoE. Physicians, dietitians, and other medical professionals should be aware of the increasing prevalence of EoE, know what to look for in its presentation, and keep up to date on the growing field of research as new therapies are being developed.Master of Public Healt