title: Increased incidence of eosinophilic esophagitis in children and adults with celiac disease.
abstract: OBJECTIVE
  Case series have suggested an association between eosinophilic esophagitis (EoE) and celiac disease (CD) in children. We analyzed a cohort of patients with CD to confirm this association in children, and determine whether it extends into adulthood.
  
  
  METHODS
  A database of patients with CD was reviewed to determine the number of patients with comorbid diagnoses of EoE. Histopathology reports of esophageal biopsies were reviewed to identify all cases of increased esophageal eosinophilia. Cases of EoE were diagnosed if biopsies revealed ≥ 15 eosinophils per high power field and associated symptoms were present. Age-adjusted and sex-adjusted standardized incidence ratios (SIR) with corresponding 95% confidence intervals (CI) were calculated in comparison to published US population-derived incidence data.
  
  
  RESULTS
  EoE was diagnosed in 4 children and 10 adults. EoE is more common compared with the general population; SIR for children was 35.6 (95% CI, 9.3-79.0) and for adults 13.1 (95% CI, 6.2-22.5). Overall, the age-adjusted and sex-adjusted SIR was 16.0 (95% CI, 8.7-25.5).
  
  
  CONCLUSIONS
  The incidence of EoE in our cohort of patients with CD was increased compared with the general population. Coexistent EoE should be considered in patients with CD who have persistent esophageal symptoms.
authors.affiliation: Division of Digestive and Liver Disease, Columbia University Medical Center, New York, NY, USA.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Thompson
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lebwohl
authors.forename: Norelle Rizkalla
authors.initials: NR
authors.lastname: Reilly
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
authors.forename: Govind
authors.initials: G
authors.lastname: Bhagat
authors.forename: Peter H R
authors.initials: PH
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D057765:Eosinophilic Esophagitis / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult