ESPE Abstracts

Introduction: Type 1 diabetes is a chronic autoimmune disease where pancreatic beta cells are destroyed, leading to insufficient insulin production. This condition is often associated with other immune and allergic disorders such as eosinophilic esophagitis, although the exact mechanisms linking these conditions are uncertain.

Objectives: This case highlights the complexity of the interaction and potential overlaps between autoimmune and allergic diseases

Clinical case: We received an 11-year-old child diagnosed with type 1 diabetes at the age of 5. He managed the condition well with good glycemic control and strictly followed a gluten-free diet due to concomitant celiac disease. Over the past month, the patient developed progressively severe moderate dysphagia without clinical signs suggesting digestive endoscopy. Biopsy results revealed severe eosinophilic esophagitis characterized by microabscess formation, interstitial jejunitis, and Marsh type 3 villous atrophy. The patient was treated with a proton pump inhibitor and injectable budesonide (due to the unavailability of local forms). This combined therapy markedly improved the child's clinical symptoms, highlighting the effectiveness of targeted interventions in managing complex autoimmune and allergic comorbidities.

Conclusion: It is crucial to identify other autoimmune and allergic disorders in children with diabetes, including eosinophilic esophagitis, even if rare, especially when there are associated digestive symptoms.