M Ancellin1, L Ricolfi-Waligova2, I Clerc-Urmès3, C Schweitzer4, R Maudinas2, M Bonneton1, A Divaret-Chauveau5. 1. Unité d'hépato-gastro-entérologie pédiatrique, hôpital d'enfants, CHRU de Nancy, 54011 Vandœuvre-Lès-Nancy, France. 2. Service de pédiatrie, hôpital d'enfants, CHU de Dijon, France. 3. DRCI, département MPI, unité de méthodologie, data management et statistique, CHRU de Nancy, 54011 Vandœuvre-Lès-Nancy, France. 4. Unité d'explorations fonctionnelles respiratoires pédiatriques, hôpital d'enfants, CHRU de Nancy, 54011 Vandœuvre-Lès-Nancy, France; EA 3450 DevAH, département de physiologie, faculté de médecine, université de Lorraine, Vandoeuvre-les-Nancy, France. 5. EA 3450 DevAH, département de physiologie, faculté de médecine, université de Lorraine, Vandoeuvre-les-Nancy, France; Unité d'allergologie pédiatrique, hôpital d'enfants, CHRU de Nancy, rue du Morvan, 54011 Vandœuvre-Lès-Nancy, France; UMR 6249 chrono-environnement, CNRS et université de Franche-Comté, Besançon, France. Electronic address: a.chauveau@chru-nancy.fr.
Abstract
INTRODUCTION: Most children with eosinophilic esophagitis (EoE) are atopic, but the impact of atopy on the remission and development of EoE is still unclear. The aim of our study was to determine the impact of atopy on remission of EoE and to describe allergy tests and the choice of treatment for a cohort of EoE children in France. METHODS: All children diagnosed with EoE between January 2013 and June 2018 in the five pediatric centers in the northeast of France were included. Children were divided into two groups according to personal atopic disorders. Histological remission was defined on the basis of an eosinophilic count below 15 eosinophils per high-power field. RESULTS: Among the 49 children included, 38 (78%) were atopic. Allergy tests were performed for 45 children (92%). Rates of sensitization were similar in both groups: 64% had food sensitization and 64% had aeroallergen sensitization. The most commonly attempted first-line therapy was with proton pump inhibitors (63%), followed by swallowed topical steroids (STS) (18%). First-line therapy was not associated with atopic status (P=0.88). Atopic children had a nonsignificant tendency for a higher remission rate after STS (55% vs. 0%, P=0.24) and a higher global remission rate (54% vs. 33%, P=0.18) compared with non-atopic children. CONCLUSION: Allergy testing is relevant in the majority of children with EoE whether or not they have atopic disorders. Atopy seems to be associated with better response to STS. Further studies are needed to determine whether atopic status determines histological response.
INTRODUCTION: Most children with eosinophilic esophagitis (EoE) are atopic, but the impact of atopy on the remission and development of EoE is still unclear. The aim of our study was to determine the impact of atopy on remission of EoE and to describe allergy tests and the choice of treatment for a cohort of EoEchildren in France. METHODS: All children diagnosed with EoE between January 2013 and June 2018 in the five pediatric centers in the northeast of France were included. Children were divided into two groups according to personal atopic disorders. Histological remission was defined on the basis of an eosinophilic count below 15 eosinophils per high-power field. RESULTS: Among the 49 children included, 38 (78%) were atopic. Allergy tests were performed for 45 children (92%). Rates of sensitization were similar in both groups: 64% had food sensitization and 64% had aeroallergen sensitization. The most commonly attempted first-line therapy was with proton pump inhibitors (63%), followed by swallowed topical steroids (STS) (18%). First-line therapy was not associated with atopic status (P=0.88). Atopic children had a nonsignificant tendency for a higher remission rate after STS (55% vs. 0%, P=0.24) and a higher global remission rate (54% vs. 33%, P=0.18) compared with non-atopic children. CONCLUSION:Allergy testing is relevant in the majority of children with EoE whether or not they have atopic disorders. Atopy seems to be associated with better response to STS. Further studies are needed to determine whether atopic status determines histological response.