14 years of eosinophilic esophagitis: clinical features and prognosis.
OBJECTIVE
To determine the natural history of treated and untreated eosinophilic esophagitis (EE) and examine the presenting symptoms of EE.


METHODS
Retrospective and prospective chart review of all patients diagnosed with EE at The Children's Hospital of Philadelphia. EE was defined as greater than 20 eosinophils per high power field after treatment with reflux medications.


RESULTS
We identified 620 patients in our database in the last 14 years and 330 patients with greater than 1 year of follow-up for analysis. The number of new EE patients has increased on an annual basis. Of the patients presenting with EE, 68% were younger than 6 years old. Reflux symptoms and feeding issues/failure to thrive were the most common presenting symptoms for EE. Eleven patients had resolution of all of their food allergies and 33 patients had resolutions of some of their food allergies. No patients have progression of EE into other gastrointestinal disorders.


CONCLUSIONS
EE is a chronic disease with less than 10% of the population developing tolerance to their food allergies. EE does not progress into other gastrointestinal diseases.
Spergel
Jonathan M
JM
Division of Allergy and Immunology, The Children's Hospital of Philadelphia, USA. spergel@email.chop.edu
Brown-Whitehorn
Terri F
TF
Beausoleil
Janet L
JL
Franciosi
James
J
Shuker
Michele
M
Verma
Ritu
R
Liacouras
Chris A
CA
D015746:Abdominal Pain; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders; D003937:Diagnosis, Differential; D016145:Endoscopy, Digestive System; D004802:Eosinophilia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D004941:Esophagitis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000178:diet therapy / Q000276:immunology; D005764:Gastroesophageal Reflux; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012621:Seasons; D012737:Sex Factors; D014839:Vomiting
D000305:Adrenal Cortex Hormones