Nina Ristic1, Radmila Jankovic2, Natasa Dragutinovic3, Marina Atanaskovic-Markovic4,5, Milica Radusinovic3, Marija Stevic5,6, Milos Ristic7, Maja Ristic8, Tamara Milovanovic5,9. 1. Department of Gastroenterology, Hepatology and GI Endoscopy, University Children's Hospital, Belgrade, Serbia, nina.ristic13@gmail.com. 2. Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. 3. Department of Gastroenterology, Hepatology and GI Endoscopy, University Children's Hospital, Belgrade, Serbia. 4. Department of Pulmonology and Allergology, University Children's Hospital, Belgrade, Serbia. 5. Faculty of Medicine, University of Belgrade, Belgrade, Serbia. 6. Department of Anesthesia, University Children's Hospital, Belgrade, Serbia. 7. Emergency Center, Clinical Center of Serbia, Belgrade, Serbia. 8. Department of Nutrition and Food Safety Control, Institute for Public Health of Belgrade, Belgrade, Serbia. 9. Clinic for Gastroenterology and Hepatology, Clinical Center<italic></italic>of Serbia, Belgrade, Serbia.
Abstract
OBJECTIVES: The aim of this study was to assess the epidemiological, clinical, endoscopic, and pathohistological characteristics of pediatric eosinophilic esophagitis (EoE) in Serbia. METHOD: All children aged 0-18 years diagnosed with EoE in the period between 2010 and 2017 at the University Children's Hospital in Belgrade, Serbia, were retrospectively enrolled. RESULTS: EoE was diagnosed in 35 children (12.45 ± 3.77 years) with a male predominance (74%). The median incidence rate was estimated to be 0.85 per 100,000 children per year with the highest rate estimated at 3.17 per 100,000 children in 2017. Dysphagia (71.4%) and food impaction (40%) were dominant symptoms. Inflammatory endoscopic changes were found in 74.3% and fibrostenotic changes in 62.9% of the children. The esophageal biopsy rate was low (6.8%), especially in children with reflux and nonspecific symptoms. Subepithelial fibrosis was found in only 20% of the patients. Since 2016, the number of biopsy samples has increased, but the sampling rate of lamina propria is still low (<50%). The correlation between the number of biopsies and lamina propria acquisition was strong (rs = 0.773, p < 0.05). In 2 immunocompetent adolescents, EoE was diagnosed after successful treatment of infectious esophagitis. CONCLUSIONS: An increase in the incidence of EoE in Serbian children is evident. The biopsy rate in children with nonspecific and reflux symptoms should be increased, as well as the number of biopsy samples for the detection of subepithelial fibrosis. In immunocompetent children with infectious esophagitis, EoE should be suspected and endoscopy may be recommended after successful treatment of infection.
OBJECTIVES: The aim of this study was to assess the epidemiological, clinical, endoscopic, and pathohistological characteristics of pediatric eosinophilic esophagitis (EoE) in Serbia. METHOD: All children aged 0-18 years diagnosed with EoE in the period between 2010 and 2017 at the University Children's Hospital in Belgrade, Serbia, were retrospectively enrolled. RESULTS: EoE was diagnosed in 35 children (12.45 ± 3.77 years) with a male predominance (74%). The median incidence rate was estimated to be 0.85 per 100,000 children per year with the highest rate estimated at 3.17 per 100,000 children in 2017. Dysphagia (71.4%) and food impaction (40%) were dominant symptoms. Inflammatory endoscopic changes were found in 74.3% and fibrostenotic changes in 62.9% of the children. The esophageal biopsy rate was low (6.8%), especially in children with reflux and nonspecific symptoms. Subepithelial fibrosis was found in only 20% of the patients. Since 2016, the number of biopsy samples has increased, but the sampling rate of lamina propria is still low (<50%). The correlation between the number of biopsies and lamina propria acquisition was strong (rs = 0.773, p < 0.05). In 2 immunocompetent adolescents, EoE was diagnosed after successful treatment of infectious esophagitis. CONCLUSIONS: An increase in the incidence of EoE in Serbian children is evident. The biopsy rate in children with nonspecific and reflux symptoms should be increased, as well as the number of biopsy samples for the detection of subepithelial fibrosis. In immunocompetent children with infectious esophagitis, EoE should be suspected and endoscopy may be recommended after successful treatment of infection.
Authors: Javier Molina-Infante; Lucia Ferrando-Lamana; Cristina Ripoll; Moises Hernandez-Alonso; Jose M Mateos; Miguel Fernandez-Bermejo; Carmen Dueñas; Nuria Fernandez-Gonzalez; Eva M Quintana; Maria Angeles Gonzalez-Nuñez Journal: Clin Gastroenterol Hepatol Date: 2010-10-01 Impact factor: 11.382
Authors: Alfredo J Lucendo; Javier Molina-Infante; Ángel Arias; Ulrike von Arnim; Albert J Bredenoord; Christian Bussmann; Jorge Amil Dias; Mogens Bove; Jesús González-Cervera; Helen Larsson; Stephan Miehlke; Alexandra Papadopoulou; Joaquín Rodríguez-Sánchez; Alberto Ravelli; Jukka Ronkainen; Cecilio Santander; Alain M Schoepfer; Martin A Storr; Ingrid Terreehorst; Alex Straumann; Stephen E Attwood Journal: United European Gastroenterol J Date: 2017-01-23 Impact factor: 4.623
Authors: Cristina Almansa; Murli Krishna; Anna M Buchner; Marwan S Ghabril; Nicholas Talley; Kenneth R DeVault; Herbert Wolfsen; Massimo Raimondo; Juan C Guarderas; Sami R Achem Journal: Am J Gastroenterol Date: 2009-02-24 Impact factor: 10.864
Authors: John Croese; Stephen K Fairley; John W Masson; André K H Chong; David A Whitaker; Peter A Kanowski; Neal I Walker Journal: Gastrointest Endosc Date: 2003-10 Impact factor: 9.427
Authors: Dorothee Zimmermann; Dominique H Criblez; Evan S Dellon; Christian Bussmann; David Pfeifer; Matthias Froh; Alex Straumann Journal: ACG Case Rep J Date: 2016-04-15