A rare combination of complicated eosinophilic esophagitis and Crohn's disease in a 17-year-old child. Case report

Eosinophilic esophagitis (EoE) and inflammatory bowel disease (IBD) are chronic immune-mediated diseases with complex pathogenesis. Little is known about overlap of EoE and IBD in pediatrics.A 17-year-old male patient was admitted to the endoscopy department of the Research Institute of Emergency Pediatric Surgery and Trauma (Moscow) with dysphagia that had been lasting for a year. For the first time EoE was diagnosed and histologically confirmed in this child 2 years ago. Since that time the patient didn’t receive any treatment and follow-up. Endoscopy confirmed eosinophilic esophagitis with esophageal stricture (E2R1E1F2S1) which was successfully corrected by the endoscopic balloon dilatation. The symptoms of dysphagia disappeared completely, but 3 months later the patient complained of blood in the stool and an anal fissure. Esophagogastroduodenoscopy revealed decreased activity of EoE (E1R0E1F1S0) without strictures. Crohn's disease was diagnosed by ileocolonoscopy with biopsy. An anal fissure was epithelized within treatment of Crohn's disease. Comorbid complicated forms of eosinophilic esophagitis and Crohn's disease in children are uncommon. Endoscopy allowed timely minimally invasive treatment of esophageal stricture as well as diagnostics of a rare combination of immune-mediated chronic diseases of digestive tract.