A Case of Eosinophilic Esophagitis Associated with Herpes Esophagitis in a Pediatric Patient

Abstract

Eosinophilic esophagitis is a rare disease in Asian countries, but its incidence is growing rapidly in Western countries. The main pathophysiology of eosinophilic esophagitis is esophageal epithelial barrier dysfunction; disruption of the esophageal epithelial barrier easily induces antigen sensitization to foods and aeroallergens, which leads to subsequent esophageal inflammation as a result of eosinophil recruitment. Here we report a case of an 11-year-old Korean boy who suffered from fever, odynophagia, dysphagia, and chest pain. His upper endoscopic findings showed longitudinal ulcers with a volcano-like appearance at the distal esophagus. Polymerase chain reaction test results and biopsy specimens were positive for herpes simplex virus type 1. He was treated with acyclovir and a proton pump inhibitor, but his follow-up endoscopy showed typical patterns of eosinophilic esophagitis, and the biopsy specimens were compatible with the diagnostic criteria for eosinophilic esophagitis. Therefore, we report a very rare case of eosinophilic esophagitis after herpes esophagitis in a Korean child with normal immunity.

A Patient with Eosinophilic Esophagitis and Herpes Simplex Esophagitis: A Case Report and Literature Review

“…Antigen-presenting cells can induce T helper 2 ( 2) cells leading to eosinophilic infiltration/inflammation of the esophageal lamina propria and submucosa [11]. Also, acute inflammation resulting from HSE can induce predominantly neutrophilic infiltrate, and EoE may be masked if there is an underlying disease [12].…”

Rare Etiology of Odynophagia in a Female Adolescent

“…The following keywords were used: “herpes simplex,” “esophagitis,” “immunocompetent,” “child,” and “adolescent.” We included all cases of HE, as defined by the World Health Organization, in immunocompetent adolescents aged between 10 and 19 years. In total, 36 cases were identified [ 4 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]; the clinical characteristics of the patients are shown in Table 1 . The mean age was 15.097 ± 2.736 years, and the male: female ratio was 6.2:1.…”

“…We included all cases of HE, as defined by the World Health Organization, in immunocompetent adolescents aged between 10 and 19 years. In total, 36 cases were identified [4,[6][7][8][9][10][11][12][13][14][15][16][17][18]; the clinical characteristics of the patients are shown in Table 1. The mean age was 15.097 ± 2.736 years, and the male: female ratio was 6.2:1.…”

An Update on Eosinophilic Esophagitis: Etiological Factors, Coexisting Diseases, and Complications

“…Similarly, a series of 5 adult patients with herpes simplex esophagitis had histological and clinical symptoms consistent with the diagnosis of EoE [108]. Kim et al [109] reported an 11-year-old Korean boy suffering from fever, odynophagia, dysphagia, and chest pain. His upper endoscopic examination of the distal esophagus revealed longitudinal ulcers with volcanic appearance.…”