Pediatric eosinophilic esophagitis among children attending a tertiary hospital in Nairobi, Kenya: a case series.

Background: Eosinophilic esophagitis (EoE) is an emerging chronic immune-mediated esophageal disorder characterized by esophageal dysfunction and dense eosinophilic infiltration of the epithelium. Despite increasing global recognition, data from sub-Saharan Africa remain scarce. Objective: The aim of this work is to describe the clinical spectrum, endoscopic and histopathologic features, and treatment outcomes of pediatric EoE cases diagnosed at a tertiary private hospital in Nairobi, Kenya. Methods: We conducted a retrospective case series of eight children, aged 4-17 years, who were diagnosed with EoE at The Aga Khan University Hospital, Nairobi. Data collected included demographics, presenting symptoms, laboratory findings, endoscopic features, histology, treatment regimens, and follow-up outcomes. Diagnosis was based on the presence of ≥15 eosinophils per high-power field in esophageal biopsies, alongside clinical and endoscopic correlation, and exclusion of other causes of esophageal eosinophilia. Results: Of the eight patients (six boys, two girls), common symptoms included dysphagia ( Conclusion: This case series highlights EoE as an important yet often overlooked cause of upper gastrointestinal symptoms in Kenyan children. Its ability to mimic other gastrointestinal disorders warrants heightened clinical suspicion, particularly in cases of refractory gastritis or dysphagia unresponsive to proton pump inhibitors. Effective management includes dietary elimination and topical corticosteroids. Larger multicenter studies are needed to define the epidemiology, diagnostic challenges, and long-term outcomes of pediatric EoE in sub-Saharan Africa and to inform clinical guidelines.