Eosinophilic esophagitis in children and adolescents: epidemiology, clinical presentation and seasonal variation.
Abstract
BACKGROUND
Eosinophilic esophagitis (EoE) is defined by infiltration of eosinophils in the esophageal mucosa (>20 eosinophils/hpf). The
epidemiology and seasonal variation have not been well studied in children and adolescents.
METHODS
Review of all esophageal biopsies performed from January 2001 to December 2006 on patients younger than 21 year of age, focusing
on demographics, onset and duration of presenting symptoms, history of allergies and endoscopic findings.
RESULTS
A total of 753 upper endoscopies were performed, 44 of which showed histologic evidence of EoE (5.8 %). Fifty percent of all
EoE endoscopies were grossly normal. Onset of symptoms was 23 % in the spring, 29 % in the summer, 23 % in the fall and 25
% in the winter. More cases (36 %) were diagnosed in the fall. Time between onset of symptoms and diagnosis was 115 ± 145
days (mean ± SD). The most common presenting symptoms were vomiting (61 %), dysphagia (39 %), abdominal pain (34 %), feeding
disorders (14 %), heartburn (14 %), food impaction (7 %), vague chest pain (5 %) and diarrhea (5 %). Children presenting with
vomiting and feeding disorders were younger (p < 0.02), whereas children presenting with heartburn and dysphagia were older
(p < 0.02).
CONCLUSIONS
The incidence of EoE did not increase between 2001 and 2006. Onset of symptoms did not vary by season, indicating that allergens
triggering EoE are present all year around. Vomiting and feeding disorders are seen in young children, while dysphagia and
heartburn are seen in older children. As endoscopic findings were normal in 50 % of cases, an esophageal biopsy should be
performed in all patients with suspected EoE.
Links
Authors
Sorser SA, Barawi M, Hagglund K, Almojaned M, Lyons H
Institution
Department of Gastroenterology, Providence Hospital, Southfield, MI 48075, USA. Serge.Sorser@stjohn.org
Source
Journal of gastroenterology 48:1 2013 Jan pg 81-5Pub Type(s)
Journal ArticleLanguage
eng
PubMed ID
22618806
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