13 October 2022: Articles
Columnar Metaplasia of the Esophagus Presenting as Iron Deficiency Anemia in Children with Neurologic Impairment or Congenital Esophageal Atresia
Challenging differential diagnosis, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology
Melissa R. Van Arsdall A* , Supriya Nair B , Lindsay M. Moye B , Trinh T. Nguyen B , Zeina M. Saleh D , J. Marc Rhoads ADOI: 10.12659/AJCR.937255
Am J Case Rep 2022; 23:e937255
Table 1. Summary of 5 pediatric cases of columnar metaplasia in the lower esophagus presenting with iron deficiency anemia.
| Case | Age (yr) | Sex | Medical history | Hgb (g/dL) | Fecal occult blood test | Distal esophageal appearance | Distal esophageal histology |
|---|---|---|---|---|---|---|---|
| 1 | 10 | Female | Severe neurologic impairment | 3.6 | Negative stool guaiac test | Ill-defined Z-line, nodularity, flame-shaped ulcerations proximal to the GEJ | GM, pseudogoblet cells |
| 2 | 15 | Male | Severe neurologic impairment | 7.0 | Positive stool guaiac test | Esophagitis, patulous LES, Z-line displaced proximally to the GEJ | GM |
| 3 | 8 | Male | EA, TEF | 8.7 | Negative fecal globin test | Z-line displaced proximally to the GEJ, patulous LES | GM, IM |
| 4 | 17 | Male | EA, TEF | 7.8 | Positive stool guaiac test | Z-line displaced proximally to the GEJ, patulous LES, edema | GM |
| 5 | 11 | Male | Severe neurologic impairment | 3.9 | Positive stool guaiac test | Erythema, superficial ulceration, clusters of bullous lesions | IM with ulceration |
| EA – esophageal atresia; TEF – tracheoesophageal fistula; GEJ – gastroesophageal junction; LES – lower esophageal sphincter; GM – gastric metaplasia; IM – intestinal metaplasia. | |||||||