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- W2521449825 abstract "A 5-year-old boy developed abdominal pain, photophobia, and an urticarial rash several days after discontinuing amoxicillin for otitis media. His medical history was unremarkable. After 10 days of these symptoms, he was admitted to our hospital: C-reactive protein was increased to 259 mg/L (normal range 0–6 mg/L) and circulating eosinophils to 1000/μL (normal range 0–400/μL). On day 3, circulating eosinophils increased to 6900/μL and C-reactive protein to 410 mg/L. Abdominal ultrasound and CT-scan showed mild hepatosplenomegaly, mesenteric adenopathy, and small bowel dilatation. Upper and lower gastrointestinal endoscopies (Fig. 1) showed unusual white eggshell-like lesions of the esophagus, stomach, and duodenum. These lesions were subsequently identified as eosinophilic abscesses on histology. Intravenous corticosteroids were started at 2 mg · kg−1 · day−1 for Drug Reaction with Eosinophilia and Systemic Symptoms syndrome. After 3 days, clinical and laboratory improvement led us to switch to oral corticosteroids. Intravenous corticosteroids had to be resumed when clinical symptoms recurred and circulating eosinophilis increased to 5200/μL. We repeated the upper endoscopy, which showed a significant improvement with complete disappearance of the esophageal lesions. The patient tolerated slow prednisone tapering during 3 months and remained asymptomatic 6 months after prednisone discontinuation (Fig. 2).FIGURE 1: A, Image of eosinophilic abscess in the esophagus. B, Image of eosinophilic abscess in the stomach. C, Biopsy of deep mucosa and submucosa with diffuse eosinophilic infiltrate. Hématéine-Eosine-Safran (HES) ×200.FIGURE 2: A, Image of lesion-free esophagus. B, Image of the duodenum with small persistent lesions." @default.
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- W2521449825 date "2016-10-01" @default.
- W2521449825 modified "2023-09-25" @default.
- W2521449825 title "Unusual Endoscopic Features in a Child With Drug Reaction With Eosinophilia and Systemic Symptoms" @default.
- W2521449825 doi "https://doi.org/10.1097/mpg.0000000000000674" @default.
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