Mahafendy ST , Juwita Pratiwi, Ninung RD Kusumawati
OBJECTIVE : Eosinophilic duodenitis is considered as an uncommon disease with a low incidence rate. The prevalence is 1/100.000 in pediatric population. Recurrent abdominal pain is one of the most common complaint in the pediatric population. A combination of acute or recurrent abdominal pain with excessive levels of eosinophils in various parts of the gastrointestinal tract suggests the diagnosis. CASE : An 11-year-old girl was admitted to hospital with recurring complaint of abdominal pain in epigastric site. Pain occured while eating, no nausea and no vomiting. Complaint was treated with esomeprazole intravenous and sucralfat, with diagnosed as gastritis. The complaint felt since 3 month before admitted to Dr.Kariadi hospital. During treatment, complaint were not improved. Abdominal ultrasound was performed and revealed no abnormalities. Gastroduodenal endoscopy revealed esophagitis, gastritis chronic erosive, duodenitis, with differential diagnosis alergic process and inflammation. Then biopsy was done. The histopatology finding of duodenal biopsy were showed active chronic gastritis, non-atrophic, non-metaplastic, non-dysplastic with negative helicobacter pylorii and shows eosinophilic duodenitis. Later patients were consulted to immunology department and threat with methylprednisolone (0,5mg/kg/day) for 1 week, gluten free and extensive hydrolyzate milk diet for 2 week. The complaint was improved with this treatment. Eosinophils are a normal constituent of the gastrointestinal tract. They can be present in any inflammatory conditions which lasts for days to weeks including eosinophilic duodenitis. The diagnostic approach is done by duodenal histopathology biopsy. Symptoms of eosinophilic duodenitis can be simliar with gastroesophageal reflux, inflammatory bowel disease, and other etiology of recurrent abdominal pain.In this patient duodenal histopathology supported the diagnosis of eosinophilic duodenitis. CONCLUSION : Patients who come with recurrent abdominal pain that have been treated according to standard procedures, but has no improvement, We have to consider with eosinophilic duodenitis.