A146 THROAT TROUBLES: CASE REPORT OF LYMPHOCYTIC ESOPHAGITIS IN A CHILD WITH DYSPHAGIA.
Notice bibliographique
Résumé
Abstract Background Lymphocytic esophagitis (LE) is a rare and poorly understood inflammatory condition of the esophagus.it is characterized by presence of lymphocyte within esophageal mucosa. It has unique histologic phenotype characterized by increased intraepithelial lymphocytes in the absence or minimal presence of intraepithelial granulocytes. It is unclear whether LE is a unique primary inflammatory esophageal disease or a marker of an underlying esophageal or systemic immune-mediated disease process. Clinical presentations range from asymptomatic to dysphagia, heartburn, chest pain, nausea, vomiting, strictures, and food bolus impaction. Given the rarity of the disease, the incidence is not well known, with one study reporting incidence of LE 0.1% of total esophageal biopsies based on the results of a large pilot study in the United States of more than 40,000 patients. Aims To report on a patient with lymphocytic esophagitis who exhibited chronic dysphagia. Methods We describe a 6-year-old male, who has a history of coughing and choking with solid foods, as well as dysphagia. Although he has not experienced food impactions, he occasionally vomits undigested food. He was evaluated previously for eosinophilic esophagitis (EoE), with an unremarkable esophagogastroduodenoscopy (EGD). He was diagnosed with gastroesophageal reflux disease (GERD) in his first weeks of life due to projectile vomiting and arching of the back after feeding. He started on proton pump inhibitors (PPIs) at 7 weeks old, continuing until he was 2 years old, with initial vomiting persisting but gradually improving over time. Results He had an upper endoscopy again at 6 years which was unremarkable macroscopically. Pathology showed features of lymphocytic esophagitis in upper/mid/distal esophagus and focal basal spongiosis in mid esophagus, no intra-epithelial eosinophils are detected in all esophageal segments. He was started on proton pump inhibitors (PPIs) with good clinical response and improvement of dysphagia and reflux symptoms. Conclusions We present a patient with a history of chronic dysphagia and histological findings of LE. LE is a rare subtype of chronic esophagitis, that can include a wide range of clinical presentations. It should be considered in the differential diagnosis of dysphagia or reflux symptoms. Patients with LE can respond to proton PPI therapy and this should be the first line of therapy. However, steroid therapy should be considered for PPI non-responder LE patients. This case raises the importance of heightened awareness regarding the clinical presentation of LE and emphasizes the need for increased recognition of this condition. Although LE seems to have a chronic but benign course, more research is needed to better understand the pathophysiology and natural history of this condition. Funding Agencies None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,002 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,003 | 0,002 |
| Communication savante | 0,002 | 0,003 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,005 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».