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Eosinophilic Esophagitis: Demographic, Clinical, Endoscopic, Histologic, and Atopic Characteristics of Children and Teenagers in a Region in Central Spain

Gómez Torrijos E1, Sánchez Miranda P2, Donado Palencia P2, Castro Jimenez A1,
Rodriguez Sánchez J3, Mendez Díaz Y1, Moreno Lozano L1, García Rodríguez R1

1Allergy Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
2Pediatric Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
3Digestive Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain

J Investig Allergol Clin Immunol 2017; Vol 27(2) : 104-110
doi: 10.18176/jiaci.0112

Background and objective: Eosinophilic esophagitis (EoE) is an increasingly prevalent chronic inflammatory disease of the esophagus with an immunoallergic etiology. Few studies have been published on EoE in children and adolescents. The objective of this study was to analyze the demographic, clinical, serologic, endoscopic-histologic, and atopic characteristics of pediatric patients with EoE and to identify atopic and digestive comorbidities.
Methods: We conducted a prospective observational study in children and adolescents (<16 years) assessed in a specialized multidisciplinary EoE unit in a tertiary referral hospital in a central region of Spain between 2011 and 2015.
Results: Thirty-five patients were included in the study. Twenty-eight (80%) were male. The mean age was 9.6 years, 83% were atopic, and 28% reported a family history of atopy. The most common symptom was dysphagia (51%). Eosinophilia was detected in the blood of 60% of patients. Eosinophil cationic protein and total IgE were elevated in 88% and 77% of patients, respectively. The most frequent endoscopic finding was linear grooves (57%). Skin tests with aeroallergens were positive in 82% of patients (pollen 62% and food 60%). The main atopic comorbidities were asthma (48%) and rhinoconjunctivitis (37%). Digestive diseases were more often associated with gastritis and Helicobacter pylori infection (17%).
Conclusions: Our results are similar to those previously reported. EoE is more common in boys and in individuals with a history of atopy and sensitization to airborne allergens and food. These results support the consideration of EoE as an atopic disease and underline the important role of allergists in early diagnosis and treatment.

Key words: Children, Teenagers, Eosinophilic esophagitis, Atopic comorbidities, Digestive comorbidities, Allergens, Esophagoscopy