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Incidence of childhood eosinophilic esophagitis in central Brazil: how many are we missing?

Gonçalves LO, Lopes MM, Rezende ER, Segundo GRS

Pediatrics Department, Clinical Hospital of Universidade Federal de Uberlândia (Uberlândia, Brazil)

J Investig Allergol Clin Immunol 2018; Vol. 28(4)
doi: 10.18176/jiaci.0241

Background: Few studies have assessed the incidence of eosinophilic esophagitis (EoE) in childhood. The study aim is to determine the incidence of EoE in pediatric patients submitted to upper gastrointestinal endoscopy (UGE), with analysis of epidemiological data regarding sex, age, symptomatology, the frequency of atopy and endoscopic and histological findings.
Methods: A retrospective, observational and analytical study performed with an evaluation of medical records of patients aged 0 to 14 years who underwent to upper gastrointestinal endoscopy in a tertiary hospital from January 2004 to January 2014.
Results: A total of 4071 upper digestive endoscopies were performed in 2651 patients. Esophageal eosinophilia was found on 405 biopsy reports, being 127with 15 or more eosinophils per high-power field in 70 different patients. Sixty-three fulfilled diagnostic criteria for EoE, three for eosinophilic gastroenteritis and four were secondary to caustic ingestion. The mean annual incidence was 2.48/100,000 individuals/year and the cumulative incidence over ten years was 24.8/100,000. No statistical difference was found between PPI-responders and non-responders regarding age, gender, atopic diseases, symptoms and endoscopic findings.
Conclusion: The incidence of EoE found in the present study was similar to that described in the literature, however. These data may be underestimated due to the difficulties to access UGE. The increased knowledge around esophageal eosinophilic diseases on childhood requires associated improvement in the health systems infrastructure.

Key words: Eosinophilic Esophagitis, Proton Pump Inhibitor Responsive Esophageal Eosinophilia, Atopic Diseases, Childhood, Prevalence