Clinical characteristics and sensitivity to food and inhalants among children with eosinophilic esophagitis.
BACKGROUND
To understand the clinical characteristics and the diagnostic procedures in pediatric patients with eosinophilic esophagitis and to evaluate the sensitivity of the patients to food and inhalant allergens. A cross-sectional study was performed in 35 children with eosinophilic esophagitis during the time period from January 2010 to January 2011. The clinical and epidemiological data were obtained using a questionnaire and medical chart analysis. The body mass index for age was used for the nutritional evaluation (via the Z score). The sensitivity to foods and inhalants was evaluated by performing a skin prick test and atopy patch test.


RESULTS
Patients (35 in total, median age 10 years) with a diagnosis of eosinophilic esophagitis were evaluated. The most prevalent symptoms in the patients were vomiting (71.4%) and abdominal pain (51.4%). Endoscopic alterations were observed in 97.2% of the patients. A good nutritional state was observed in 82.8% of the children. The tests demonstrated the presence of food sensitivities and/or aeroallergens in 27 (77.1%) patients, whereas 8 (22.9%) patients did not test positive in any of the tests performed. Among the patients with positive tests, 24 (68.5%) exhibited sensitivity to aeroallergens and 16 (45.7%) were sensitive to foods. The comparison between the sensitive and insensitive groups displayed statistically significant results with respect to sex, symptom prevalence, and 24-hour esophageal pH monitoring.


CONCLUSIONS
The patients evaluated in this study displayed clinical characteristics of eosinophilic esophagitis similar to those reported in the literature. The sensitivity to foods determined by the tests was less than that observed in prior studies; however, a marked sensitivity to aeroallergens was observed. The different allergen sensitivity profiles observed in this study suggests that, similar to asthma, the eosinophiic esophagitis disease may exhibit several phenotypes.
Erica Rodrigues Mariano de Almeida
ER
Rezende
Cristina Palmer
CP
Barros
Leandro Hideki
LH
Ynoue
Amanda Torido
AT
Santos
Rogerio Melo Costa
RM
Pinto
Department of Pediatrics, Universidade Federal de Uberlandia, Uberlandia, Minas Gerais, Brazil. gesmar@famed.ufu.br.
Gesmar Rodrigues Silva
GR
Segundo
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000485:Allergens / Q000009:adverse effects*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D057765:Eosinophilic Esophagitis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D050782:Esophageal pH Monitoring; D004945:Esophagoscopy; D005512:Food Hypersensitivity / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000235:genetics; D007223:Infant; D010328:Patch Tests; D012130:Respiratory Hypersensitivity / Q000150:complications* / Q000175:diagnosis; D012882:Skin Tests; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000209:etiology
D000485:Allergens