Prevalence of Eosinophilic Esophagitis in Adolescents With Esophageal Atresia

J Pediatr Gastroenterol Nutr. 2019 Jul;69(1):52-56. doi: 10.1097/MPG.0000000000002261.

Abstract

Background and objective: Eosinophilic esophagitis (EoE) is an increasingly recognized childhood disease. Esophageal atresia (EA) is the most frequent congenital malformation of the esophagus. Recently, cases of EoE occurring in patients with EA have been reported, although the exact prevalence of EoE in EA remains unknown. The aim is to investigate the prevalence of EoE among EA in adolescents and to describe these patients' characteristics.

Methods: Systematic upper gastrointestinal endoscopies with multistage esophageal biopsies were prospectively performed in 63 adolescents with EA. A standardized form was used to collect clinical and endoscopic data. Diagnosis of EoE was made as ≥15 intraepithelial eosinophils/high power field, whatever the response on proton pump inhibitors therapy.

Results: Six patients (9.5%) presented an EoE (17-100 eosinophils/high power field). An atopic condition was reported more frequently in the eosinophil ≥15 group than in patients with no EoE (66% vs 16%; P = 0.014). Except for chest pain, symptoms and endoscopic features were similar in patients with EoE and patients with no EoE.

Conclusion: In our series of 63 patients born with EA, mainly distal tracheoesophageal fistula, the prevalence of EoE is increased, and therefore should be considered in adolescents with EA.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Chest Pain / epidemiology
  • Endoscopy, Gastrointestinal
  • Eosinophilic Esophagitis / complications
  • Eosinophilic Esophagitis / diagnostic imaging
  • Eosinophilic Esophagitis / epidemiology*
  • Eosinophilic Esophagitis / pathology*
  • Eosinophils / pathology*
  • Erythema / etiology
  • Esophageal Atresia / epidemiology*
  • Female
  • Humans
  • Hypersensitivity / epidemiology
  • Leukocyte Count
  • Male
  • Prevalence
  • Prospective Studies
  • Proton Pump Inhibitors / therapeutic use
  • Tracheoesophageal Fistula / epidemiology*
  • Ulcer / etiology

Substances

  • Proton Pump Inhibitors

Supplementary concepts

  • Esophageal atresia with or without tracheoesophageal fistula