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Eosinophilic oesophagitis — RACP Paediatrics MCQ

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ModerateGIEosinophilic oesophagitisRACP Paediatrics

A 10-year-old presents with chronic dysphagia, food bolus impaction, and heartburn. Endoscopy shows linear furrows and white exudates in the oesophagus. Biopsies show >15 eosinophils per high-power field in the oesophageal mucosa. What is the most likely diagnosis?

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Correct answer: E — Eosinophilic oesophagitis

Eosinophilic oesophagitis (EoE) presents with dysphagia, food impaction, and heartburn in older children. Endoscopy shows characteristic features (linear furrows, white exudates/plaques, rings). Diagnosis requires ≥15 eosinophils/HPF on oesophageal biopsy after exclusion of other causes. Treatment includes swallowed topical corticosteroids (fluticasone/budesonide) or dietary elimination.

Reference: RCH Melbourne – 2023 – Eosinophilic Oesophagitis CPG; RACP Paediatric Curriculum – GI