An enigma of eosinophilic esophagitis Enigma eozinofilnog ezofagitisa

Introduction. Eosinophilic esophagitis is a chronic immunogenic/antigen mediated disease esophagus, characterized by symptoms related esophagus dysfunction, histologically defined by over 15 eosinophil seen in high-power microscopic field, without gastroesophageal disease. In adults, most common clinical manifestations are dysphagia, reflux, chest pain, regurgitation bolus impaction. Case study. In this paper we present case a female patient, hospitalized for a serious form pancreatitis with complications, required artificial ventilation enteral feeding, after initial esophagoscopy reflux esophagitis. Further treatment cured primary illness, peroral feeding was reintroduced. However, dysphagia with regurgitation occurred, and endoscopic radiological tests verified esophagus stenosis, which pathohistologically corresponded to erosive esophagitis. Two months of treatment by a double dosage proton pump inhibitors led to no disorders, repeated biopsies from stenotic segments resulted in over 30 eosinophil counts in high-power microscopic field, which histologically corresponds to eosinophilic esophagitis. Subsequent included fluticasone 880 mcg orally for a period eight weeks, led complete regression disorders, endoscopic pathohistologic remission. Conclusion. The paper presents case a female patient with esophageal clinical symptomatology. In case irresponsiveness to conventional therapy by proton pump inhibitors, repeated esophagoscopy and pathohistological analyses esophagus mucosa biopsy can point to the diagnosis eosinophilic esophagitis, a good therapeutic response topical corticosteroids can be regarded as clinical confirmation the diagnosis.