Etiology of chronic esophagitis in children

Abstract

Chronic esophagitis in children is heterogeneous in etiology. A study covered 83 patients aged 3 to 17 years with histologically defined chronic esophagitis, 58 of them suffered from food and respiratory allergies. All children underwent endoscopy, morphological and immune-histochemical study of biopsies of esophagus to check presence of mucosal IgE, IgA, herpes simplex virus, cytomegalovirus and Epstein – Barr virus. Chronic infection was found in 77 of 83 (92.8%) children. All the patients underwent daily pH meter. Gastroesophageal reflux disease was diagnosed in 33 children, characterized by typical symptoms combined with gastroduodenal pathology, usually HP-associated, and increased gastric secretion. Mild inflammation was morphologically identified in 15% of patients with gastric metaplasia. Allergic esophagitis was not associated with either clinical or endoscopic obvious manifestations; eosinophilic infiltration was observed in several patients, inflammatory activity was lower than at gastroesophageal reflux disease or infections. Esophagitis in chronic viral infection was characterized by higher frequency of erosive changes and more marked inflammation. The combination of three etiological factors is associated with a more severe lesion of esophagus.

Keywords

• хронический эзофагит
• гастроэзофагеальная рефлюксная болезнь
• герпетическая инфекция
• chronic esophagitis
• gastroesophageal reflux disease
• herpes infection