The Possible Link between Eosinophilic Esophagitis and Caustic-Induced Esophagitis: A Prospective Study in the Poison Control Center of Ain Shams University Hospitals

Hussien, Rania; Abdel-Aziz, Mohamed AA; Ashry, Soha; Eweda, Sarah Atef

doi:10.21608/esctj.2024.344603.1078

The Possible Link between Eosinophilic Esophagitis and Caustic-Induced Esophagitis: A Prospective Study in the Poison Control Center of Ain Shams University Hospitals

Document Type : Original Article

Authors

¹ Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain shams university, Cairo, Egypt

² Poison Control Center Lab, Ain Shams University hospitals

³ Clinical Toxicology ,Medical education, College of Medicine, Jouf University, Kingdom of Saudi Arabia

10.21608/esctj.2024.344603.1078

Abstract

Background: Corrosive ingestion is a common health problem in developing countries. Previous case reports suggested possible association between caustic injury of the esophagus and eosinophilic esophagitis (EoE). Aim of the work: This study aimed to explore the immunological mechanisms underlying caustic-induced esophagitis, particularly the role of IgE and eosinophilic responses and thus, identify individuals who may benefit from targeted treatments, such as immunomodulatory or anti-inflammatory therapies. Patients and methods: This prospective study included patients with corrosive ingestion admitted to the Poison Control Center of Ain Shams University Hospitals between July and December 2022. Investigations included complete blood count, serum IgE, serum cortisol, C-reactive protein (CRP), and alpha-1 antitrypsin (AAT), with blood samples collected within 24 hours and repeated at 72 hours following ingestion. Results: Thirty children were enrolled and categorized into stricture and non-stricture groups. A significant rise in serum IgE, eosinophil count, AAT was observed in the second sample compared to the first. High levels of IgE, AAT and CRP were significantly associated with the development of esophageal strictures. Conclusion: This study concluded that elevated IgE levels following caustic ingestion, along with their association with the development of esophageal strictures, may suggest an immune based mechanism underlying caustic injury-induced strictures. Identifying this mechanism could open avenues for targeted therapeutic approaches, such as the early use of anti-IgE therapies to enhance patient outcomes and reduce the risk of long-term complications.

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