# Eosinophilic Esophagitis Complicated by an Esophageal Stricture in a 15-Month-Old Child

## TL;DR

A 15-month-old child developed an esophageal stricture due to eosinophilic esophagitis, the youngest reported case, suggesting fibrostenosis may be a distinct disease phenotype.

## Contribution

This is the youngest reported case of esophageal stricture in eosinophilic esophagitis, suggesting a distinct disease phenotype.

## Key findings

- Fibrostenotic complications are rare in children with EoE, with stricture rates around 3.4%.
- The youngest previously documented case of EoE-related stricture was in a 3-year-old child.
- Early evaluation of EoE is crucial due to the potential for early stricture development.

## Abstract

Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disorder characterized by dysphagia, food impactions, and esophageal eosinophilia, which can lead to fibrosis and the formation of strictures. While fibrostenotic complications are relatively rare in children, studies have shown that up to 86% of adults with EoE experience dysphagia and esophageal narrowing, compared to only 6% in children. Furthermore, the incidence of stricture formation in children remains low, with reported rates of approximately 3.4%. The youngest child previously documented with this complication was 3 years old. Risk factors for fibrostenosis in EoE include older age, prolonged disease duration, and increased symptom frequency. This represents the youngest known presentation of such a case and suggests that fibrostenosis may be a distinct phenotype of the disease, rather than merely a progression from the inflammatory form. This case underscores the importance of early and thorough evaluation of EoE, given the potential for early stricture development.