Diana Colson1, Nicolas Kalach2, Pascale Soulaines3, Yves Vannerom4, Florence Campeotto3, Cecile Talbotec3, Lucienne Chatenoud5, Régis Hankard6, Christophe Dupont7. 1. Hôpital Necker - Enfants Malades, Université Paris Descartes, Paris, France; Nutricia Nutrition Clinique, Saint-Ouen, France. 2. Hôpital Necker - Enfants Malades, Université Paris Descartes, Paris, France; Clinique Pédiatrique Saint Antoine, Hôpital Saint Vincent de Paul, Groupement des Hôpitaux de l'Institut Catholique de Lille, France. 3. Hôpital Necker - Enfants Malades, Université Paris Descartes, Paris, France. 4. Cabinet de pédiatrie, Boulogne, France. 5. Hôpital Necker - Enfants Malades, Université Paris Descartes, Paris, France; Laboratoire d'Immunologie Biologie, Hôpital Necker - Enfants Malades, Paris, France. 6. INSERM 1069, CHRU Tours, F-37000, Tours; Univ. F. Rabelais, Tours. France. 7. Hôpital Necker - Enfants Malades, Université Paris Descartes, Paris, France; Clinique Pédiatrique Saint Antoine, Hôpital Saint Vincent de Paul, Groupement des Hôpitaux de l'Institut Catholique de Lille, France. Electronic address: christophe.dupont@nck.aphp.fr.
Abstract
BACKGROUND: Eosinophilic esophagitis (EoE) is a clinicopathologic disease that presents with a massive infiltration of the esophagus by eosinophils triggered by food antigen(s). OBJECTIVE: To determine the impact of dietary therapy on nutritional parameters in patients who present with EoE. METHODS: A convenience retrospective study analyzed patients with EoE after a 2-month dietary therapy (6-food elimination diet, avoidance of the 6 most common allergenic foods, plus avoidance of those eliciting positive skin testing, plus amino-acid formula as replacement for dairy products). Pre- and postdiet allergic and nutritional status were evaluated. RESULTS: Of 111 eligible patients, 59 patients, with a median age of 77.7 months (range, 9-189 months) were enrolled. Dietary therapy significantly increased the return to normal endoscopic appearance (47.4%, P < .0009) and led to complete remission (<5 eosinophils/esophageal HPF and disappearance of symptoms) in 59.3%. All symptoms improved, digestive (98.3%), cutaneous (80%), and respiratory (92.8%). The prediet median weight-for-height (WFH) z score was -0.75 (-3.00 to 5.69), and the postdiet WFH did not significantly differ, -0.51 (-3.09 to 5.00). The prediet WFH z score was less than -2 (moderate malnutrition) in 10.1%. Postdiet blood eosinophils counts decreased in absolute numbers and in counts ≥ 500 × 10(6)/L (P < .0001). Evaluation after 1 year of progressive reintroduction of eliminated foods was available in 33 children: the median WFH z score did not significantly improve, from -0.89 (range, -3.00 to 0.67) at enrollment to -0.59 (range, -3.66 to 2.24). CONCLUSION: The nutritional status of children with EoE was mildly affected and not worsened by the 2-month dietary therapy.
BACKGROUND:Eosinophilic esophagitis (EoE) is a clinicopathologic disease that presents with a massive infiltration of the esophagus by eosinophils triggered by food antigen(s). OBJECTIVE: To determine the impact of dietary therapy on nutritional parameters in patients who present with EoE. METHODS: A convenience retrospective study analyzed patients with EoE after a 2-month dietary therapy (6-food elimination diet, avoidance of the 6 most common allergenic foods, plus avoidance of those eliciting positive skin testing, plus amino-acid formula as replacement for dairy products). Pre- and postdiet allergic and nutritional status were evaluated. RESULTS: Of 111 eligible patients, 59 patients, with a median age of 77.7 months (range, 9-189 months) were enrolled. Dietary therapy significantly increased the return to normal endoscopic appearance (47.4%, P < .0009) and led to complete remission (<5 eosinophils/esophageal HPF and disappearance of symptoms) in 59.3%. All symptoms improved, digestive (98.3%), cutaneous (80%), and respiratory (92.8%). The prediet median weight-for-height (WFH) z score was -0.75 (-3.00 to 5.69), and the postdiet WFH did not significantly differ, -0.51 (-3.09 to 5.00). The prediet WFH z score was less than -2 (moderate malnutrition) in 10.1%. Postdiet blood eosinophils counts decreased in absolute numbers and in counts ≥ 500 × 10(6)/L (P < .0001). Evaluation after 1 year of progressive reintroduction of eliminated foods was available in 33 children: the median WFH z score did not significantly improve, from -0.89 (range, -3.00 to 0.67) at enrollment to -0.59 (range, -3.66 to 2.24). CONCLUSION: The nutritional status of children with EoE was mildly affected and not worsened by the 2-month dietary therapy.
Authors: Brittany T Hines; Matthew A Rank; Benjamin L Wright; Lisa A Marks; John B Hagan; Alex Straumann; Matthew Greenhawt; Evan S Dellon Journal: Ann Allergy Asthma Immunol Date: 2018-05-16 Impact factor: 6.347
Authors: Matthew A Rank; Rajiv N Sharaf; Glenn T Furuta; Seema S Aceves; Matthew Greenhawt; Jonathan M Spergel; Yngve T Falck-Ytter; Evan S Dellon Journal: Ann Allergy Asthma Immunol Date: 2020-05 Impact factor: 6.347