Eosinophilic oesophagitis in infants and children in the region of southern Denmark: a prospective study of prevalence and clinical presentation.
OBJECTIVE
Eosinophilic oesophagitis (EE) is a clinical entity characterised by a set of symptoms and eosinophilic infiltration of the oesophageal epithelium. Recent reports indicate that EE is increasingly diagnosed in paediatric patients. We aimed to evaluate the epidemiology of paediatric EE in a European population.


METHODS
Infants and children in the Region of Southern Denmark were prospectively referred for further evaluation of symptoms of gastroesophageal reflux disease (GERD) after treatment failure with a proton pump inhibitor. The evaluation included endoscopy, 24-hour oesophageal pH-metry, histology of oesophageal biopsies, and investigations for food allergy (double-blind, placebo-controlled food challenge, skin prick test, S-IgE antibodies, atopy patch test).


RESULTS
Of the 78 referred patients, 28 qualified for a diagnosis of GERD. Six children had >15 eosinophils per high-power field in biopsies from the oesophageal mucosa and qualified for the diagnosis of EE. The median age at diagnosis was 9.6 years. In 4 of the 6 patients, food allergy was confirmed by double-blind, placebo-controlled food challenge. In the Region of Southern Denmark with a paediatric population of 256,164 between 0 and 16 years of age, a yearly incidence of EE of 0.16/10,000 was estimated.


CONCLUSIONS
We report a European prospective study of EE. It was documented in 6 of 78 patients with symptoms of GERD corresponding to an annual incidence of 0.16/10,000 infants and children.
Dalby
Kasper
K
Hans Christian Andersen Children's Hospital, Denmark. Kasperdalby@yahoo.com
Nielsen
Rasmus G
RG
Kruse-Andersen
Soren
S
Fenger
Claus
C
Bindslev-Jensen
Carsten
C
Ljungberg
Susanne
S
Larsen
Kirsten
K
Walsted
Anne-Mette
AM
Husby
Steffen
S
D000293:Adolescent; D000367:Age Factors; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D004311:Double-Blind Method; D057765:Eosinophilic Esophagitis / Q000150:complications / Q000453:epidemiology*; D004804:Eosinophils; D004947:Esophagus / Q000276:immunology*; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008297:Male; D009092:Mucous Membrane / Q000276:immunology; D015995:Prevalence; D011446:Prospective Studies