title: The otolaryngologic manifestations in children with eosinophilic esophagitis.
abstract: OBJECTIVE
  (1) To describe the incidence of eosinophilic esophagitis (EoE) in the population of patients undergoing esophagoscopy with biopsy by a pediatric otolaryngology service. (2) To elucidate the demographics, presenting symptoms, and endoscopic findings in children with EoE.
  
  
  METHODS
  Case series.
  
  
  METHODS
  The reports of esophageal biopsy specimens taken over 5 years in 2429 patients were reviewed. Ninety-two patients who received their initial diagnosis of EoE by the pediatric otolaryngology service with specimens showing 15 or greater eosinophils per high power field (HPF) were included.
  
  
  METHODS
  The demographic data, history, presenting symptoms, and endoscopic findings were reviewed retrospectively for the patients.
  
  
  METHODS
  The percentage of children diagnosed with EoE of all children undergoing esophageal biopsy.
  
  
  RESULTS
  A total of 92 children were diagnosed with EoE (3.8% of total children biopsied). The mean age at biopsy was 4.4 years, much lower than previously reported in the literature (approximately 8 years); 73% were boys and 27% girls. The main presenting symptom was cough (46%) followed by hoarseness, throat clearing, burping/vomiting, and abdominal pain. Forty three percent had a history of asthma and 17% a history of GERD. Half of patients had esophageal edema, a third were normal, and only a quarter had mucosal furrowing on endoscopic examination.
  
  
  CONCLUSIONS
  EoE is increasingly diagnosed as a clinical entity with a distinct symptom profile and etiology. Increased understanding of EoE and its predisposing factors requires a multidisciplinary approach to diagnosis and management involving the pediatric otolaryngologist.
authors.affiliation: Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, United States. todd.otteson@chp.edu
authors.forename: Todd D
authors.initials: TD
authors.lastname: Otteson
authors.forename: Belinda A
authors.initials: BA
authors.lastname: Mantle
authors.forename: Margaretha L
authors.initials: ML
authors.lastname: Casselbrant
authors.forename: Alka
authors.initials: A
authors.lastname: Goyal
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003937:Diagnosis, Differential; D057765:Eosinophilic Esophagitis / Q000175:diagnosis* / Q000453:epidemiology*; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D007223:Infant; D008297:Male; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology