Mordechai Slae1, Rabin Persad2, Aldrich Jing-Tao Leung3, Raniah Gabr4, Dion Brocks5, Hien Quoc Huynh6. 1. Pediatric GI and Nutrition, Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy (ECHA), 4th Floor, Room 4-579, 11405 - 87th Avenue, Edmonton, AB, T6G 1C9, Canada. slae@ualberta.ca. 2. Pediatric GI and Nutrition, Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy (ECHA), 4th Floor, Room 4-579, 11405 - 87th Avenue, Edmonton, AB, T6G 1C9, Canada. Rabin.persad@albertahealthservices.ca. 3. Pediatric GI and Nutrition, Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy (ECHA), 4th Floor, Room 4-579, 11405 - 87th Avenue, Edmonton, AB, T6G 1C9, Canada. ajleung@ualberta.ca. 4. Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 2-142H Katz Group Centre, 87 Ave and 114 St, Edmonton, AB, T6G 2J7, Canada. gabr@ualberta.ca. 5. Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 2-142H Katz Group Centre, 87 Ave and 114 St, Edmonton, AB, T6G 2J7, Canada. dbrocks@ualberta.ca. 6. Pediatric GI and Nutrition, Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy (ECHA), 4th Floor, Room 4-579, 11405 - 87th Avenue, Edmonton, AB, T6G 1C9, Canada. hien.huynh@ualberta.ca.
Abstract
BACKGROUND: Despite accumulating data on the pathogenesis of eosinophilic esophagitis, not much is known about risk factors for the development of the disease. The role of factors such as smoking, breastfeeding, early antibiotic exposure and other factors that have been associated with other allergic diseases has not been well studied in children with eosinophilic esophagitis. AIM: To explore the role of environmental and medication exposures in the development of pediatric eosinophilic esophagitis. METHODS: We conducted a cross-sectional case-control study, utilizing a parent and child questionnaire and medical chart review. Urine cotinine levels, measured by high-performance liquid chromatography, were obtained as objective evidence for smoking exposure. RESULTS: One hundred and two children with eosinophilic esophagitis and 167 controls were recruited. The controls were mainly diagnosed with functional gastrointestinal disorders (33%) and gastroesophageal reflux disease (29%). Food allergy, specifically for peanuts and tree nuts, and allergy to pollen, tree, and grass were significantly higher among eosinophilic esophagitis children. Smoking exposure, both primary and secondary, was not associated with pediatric eosinophilic esophagitis when compared to controls (odds ratio 0.96, 95% confidence interval 0.58-1.59). Furthermore, early smoking exposure in the first year of life was higher among controls. Common accepted risk factors for allergy and atopy, such as breastfeeding practices, antibiotics exposure, animals' exposure, and others, were not found to be associated with eosinophilic esophagitis in our study. CONCLUSION: Common risk factors in other allergic and atopic conditions were not found to be associated with eosinophilic esophagitis.
BACKGROUND: Despite accumulating data on the pathogenesis of eosinophilic esophagitis, not much is known about risk factors for the development of the disease. The role of factors such as smoking, breastfeeding, early antibiotic exposure and other factors that have been associated with other allergic diseases has not been well studied in children with eosinophilic esophagitis. AIM: To explore the role of environmental and medication exposures in the development of pediatric eosinophilic esophagitis. METHODS: We conducted a cross-sectional case-control study, utilizing a parent and child questionnaire and medical chart review. Urine cotinine levels, measured by high-performance liquid chromatography, were obtained as objective evidence for smoking exposure. RESULTS: One hundred and two children with eosinophilic esophagitis and 167 controls were recruited. The controls were mainly diagnosed with functional gastrointestinal disorders (33%) and gastroesophageal reflux disease (29%). Food allergy, specifically for peanuts and tree nuts, and allergy to pollen, tree, and grass were significantly higher among eosinophilic esophagitischildren. Smoking exposure, both primary and secondary, was not associated with pediatric eosinophilic esophagitis when compared to controls (odds ratio 0.96, 95% confidence interval 0.58-1.59). Furthermore, early smoking exposure in the first year of life was higher among controls. Common accepted risk factors for allergy and atopy, such as breastfeeding practices, antibiotics exposure, animals' exposure, and others, were not found to be associated with eosinophilic esophagitis in our study. CONCLUSION: Common risk factors in other allergic and atopic conditions were not found to be associated with eosinophilic esophagitis.
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