Eosinophilic esophagitis in children with celiac disease.
OBJECTIVE
Eosinophilic esophagitis and celiac disease are distinct gastrointestinal disorders. The present study in children highlights the possible coexistence of these two conditions. This study also analyzes the epidemiological and clinical profiles of these patients.


METHODS
The medical records of patients diagnosed with celiac disease from 1 April 1999 to 31 March 2007 were reviewed. Patients with coincident histological diagnosis of eosinophilic esophagitis were retrospectively identified. The presenting symptoms, laboratory evaluations, endoscopic and histopathological findings, and treatment and follow-up outcomes of these patients were analyzed.


RESULTS
Of the 221 patients with celiac disease, seven (3.2%) were also diagnosed with eosinophilic esophagitis. A majority (6/7) presented with periumbilical pain and diarrhea. None had dysphagia. Each patient had abnormal celiac screening tests. Three patients had peripheral blood eosinophilia and elevated eosinophil cationic protein. Endoscopic changes of eosinophilic esophagitis and celiac disease were apparent in the majority of patients (6/7). A gluten-free diet was instituted in every patient. Topical corticosteroid therapy was started in one patient at diagnosis and in another patient after repeat endoscopic and histopathological evaluations.


CONCLUSIONS
Awareness of the potential coexistence of eosinophilic esophagitis and celiac disease should promote optimal diagnosis of these conditions. Routine esophageal biopsies may be warranted when investigating for celiac disease.
Ooi
Chee Y
CY
Department of Gastroenterology, Sydney Children's Hospital, Randwick, NSW, Australia.
Day
Andrew S
AS
Jackson
Reuben
R
Bohane
Tim D
TD
Tobias
Vivienne
V
Lemberg
Daniel A
DA
D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D002446:Celiac Disease / Q000150:complications* / Q000473:pathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D018753:Diet, Protein-Restricted; D016145:Endoscopy, Digestive System; D004802:Eosinophilia / Q000150:complications* / Q000473:pathology / Q000628:therapy; D004941:Esophagitis / Q000150:complications* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones