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Eosinophilic esophagitis in Portuguese children: clinical and allergological characterisation

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Clinical and Translational Allergy20155(Suppl 3):P44

https://doi.org/10.1186/2045-7022-5-S3-P44

Published: 30 March 2015

Keywords

  • Frequent Symptom
  • Allergic Sensitization
  • Eosinophilic Esophagitis
  • Sensitization Profile
  • Clinicopathologic Entity

Introduction

Eosinophilic esophagitis (EoE) is a clinicopathologic entity defined by symptoms of esophageal dysfunction and histological eosinophil (eos) inflammation. Its patients (pts) commonly present concurrent reactivity to both food and aeroallergens, outlining the importance of an allergological evaluation.

Objectives

Clinical and sensitization profile description of the pediatric population with EoE diagnosis (EoEd) in our Immunoallergology Department.

Methods

Retrospective study using the EoE database (Feb2009-Mar2014) of pts up to 18 years (yrs). Outcomes were characterization of demographic, symptomatic, laboratorial (peripheral eos, total and specific IgE), endoscopic and histological features and sensitization profile (prick and patch tests).

Results

We included 24 pts [(21M,3F;10.6(4-16)yrs)]; median age at EoEd: 7(1-14)yrs. Average between symptom onset and EoEd:19±30 months. Average follow-up for 28 (5-60) months.

Most frequent symptoms (%): dysphagia (54), impaction (50), GERD-like symptoms (42), abdominal and/or epigastric pain (42), vomiting (33). Most frequent onset symptom: dysphagia (46%). 96% of pts had prior history of atopy (p<0.001). Average peripheral Eos count 627cel/mL (170-1830) and total IgE 524kU/L (25-2798). At EoEd, the most common endoscopic finding were furrows(79.2%). Histologically 29% had>40eos/High Power Field and 33% had microabcesses (which were more frequent in patients with impactation [p<0.1]).

After EoEd, 96% had confirmed allergy with 92% to aeroallergens (p<0.01) and 75% to food (P=0.023).The main allergens were(%): food [shelfish(61), milk(44), cereals(39), egg(39), meat(33), nuts(33), fish(22), fresh fruits(11)]; mites (75); pollens (54.2).

After a 12 month therapy, all had symptomatic improvement; with 8.3% achieving biopsy normalization.

Of those with pre-EoEd allergenic testing, all had acquisition of new sensitizations (food and/or aeroallergens) after EoEd.

Conclusions

The first and the most frequent symptom was dysphagia. The prevalence of allergic sensitization was >95%. The potential clinical severity of EoE justifies the multidisciplinary evaluation for clinical, diagnostic and therapeutic workup.

Authors’ Affiliations

(1)
Immuneallergology Department, Hospital de Santa Maria, CHLN, Lisbon, Portugal

Copyright

© Marcelino et al; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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