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.
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.
Authors: Jonathan E Teitelbaum; Victor L Fox; Frank J Twarog; Samuel Nurko; Don Antonioli; Gerald Gleich; Kamran Badizadegan; Glenn T Furuta Journal: Gastroenterology Date: 2002-05 Impact factor: 22.682
Authors: Seema Khan; Susan R Orenstein; Carlo Di Lorenzo; Samuel A Kocoshis; Philip E Putnam; Luther Sigurdsson; Theresa M Shalaby Journal: Dig Dis Sci Date: 2003-01 Impact factor: 3.199
Authors: Eileen S Alexander; Lisa J Martin; Margaret H Collins; Leah C Kottyan; Heidi Sucharew; Hua He; Vincent A Mukkada; Paul A Succop; J Pablo Abonia; Heather Foote; Michael D Eby; Tommie M Grotjan; Alexandria J Greenler; Evan S Dellon; Jeffrey G Demain; Glenn T Furuta; Larry E Gurian; John B Harley; Russell J Hopp; Amir Kagalwalla; Ajay Kaul; Kari C Nadeau; Richard J Noel; Philip E Putnam; Karl F von Tiehl; Marc E Rothenberg Journal: J Allergy Clin Immunol Date: 2014-09-22 Impact factor: 10.793