title: Clinical manifestations, treatment, and outcomes of children and adolescents with eosinophilic esophagitis.
abstract: OBJECTIVE
  This study aimed to describe the clinical, endoscopic, and histologic characteristics, as well as the response to conventional treatment of pediatric patients with the classical form of eosinophilic esophagitis (EoE).
  
  
  METHODS
  Study of clinical, laboratory, endoscopic, and histologic data and response to conventional treatment of 43 previously followed pediatric patients with the classical form of EoE.
  
  
  RESULTS
  A total of 43 patients diagnosed with EoE were included in the study, of which 37 were males (86%), with a mean age of 8.4 years. The most common symptoms were: nausea, vomiting, and abdominal pain (100%) in children younger than 7 years, and loss of appetite (60%), heartburn (52%), and food impaction (48%) in children older than 7 years and adolescents. Regarding the endoscopic findings, 12 (28%) patients had whitish plaques on the esophageal lining, 8 (18.5%) had longitudinal grooves, 2 (4.5%) had concentric rings, 3 (7%) had longitudinal grooves and whitish plaques, and the remaining 18 (42%) had esophageal mucosa with normal appearance. Despite the initial favorable response, 76.7% of patients required more than one course of corticosteroid therapy (systemic or aerosol) and diet (exclusion or elimination of food or elementary allergens). Persistence of eosinophil infiltration was found in some patients despite favorable clinical response.
  
  
  CONCLUSIONS
  The classic form of EoE typically shows different symptoms according age range. A significant number of patients required more than one treatment cycle to show clinical remission. Endoscopic and histologic improvement was observed; however, eosinophilic infiltration persisted in some patients.
authors: Departamento de Gastroenterologia e Hepatologia, Hospital das Clínicas, Universidade de São Paulo USP, São Paulo, SP, Brazil. maraci@uol.com.br
authors: Maraci
authors: M
authors: Rodrigues
authors: Maria Fernanda M
authors: MF
authors: D'Amico
authors: Fatima Regina Almeida
authors: FR
authors: Patiño
authors: Dorina
authors: D
authors: Barbieri
authors: Aderson Omar Mourão Cintra
authors: AO
authors: Damião
authors: Aytan M
authors: AM
authors: Sipahi
authors: Aytan M
authors: AM
authors: Sipahy
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D016145:Endoscopy, Digestive System; D057765:Eosinophilic Esophagitis / Q000150:complications / Q000178:diet therapy / Q000378:metabolism / Q000473:pathology; D004804:Eosinophils / Q000378:metabolism; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007073:Immunoglobulin E