title: The impact of dietary therapy on clinical and biologic parameters of pediatric patients with eosinophilic esophagitis.
abstract: BACKGROUND
  Eosinophilic esophagitis (EoE) is a clinicopathologic disease that presents with a massive infiltration of the esophagus by eosinophils triggered by food antigen(s).
  
  
  OBJECTIVE
  To determine the impact of dietary therapy on nutritional parameters in patients who present with EoE.
  
  
  METHODS
  A convenience retrospective study analyzed patients with EoE after a 2-month dietary therapy (6-food elimination diet, avoidance of the 6 most common allergenic foods, plus avoidance of those eliciting positive skin testing, plus amino-acid formula as replacement for dairy products). Pre- and postdiet allergic and nutritional status were evaluated.
  
  
  RESULTS
  Of 111 eligible patients, 59 patients, with a median age of 77.7 months (range, 9-189 months) were enrolled. Dietary therapy significantly increased the return to normal endoscopic appearance (47.4%, P < .0009) and led to complete remission (<5 eosinophils/esophageal HPF and disappearance of symptoms) in 59.3%. All symptoms improved, digestive (98.3%), cutaneous (80%), and respiratory (92.8%). The prediet median weight-for-height (WFH) z score was -0.75 (-3.00 to 5.69), and the postdiet WFH did not significantly differ, -0.51 (-3.09 to 5.00). The prediet WFH z score was less than -2 (moderate malnutrition) in 10.1%. Postdiet blood eosinophils counts decreased in absolute numbers and in counts ≥ 500 × 10(6)/L (P < .0001). Evaluation after 1 year of progressive reintroduction of eliminated foods was available in 33 children: the median WFH z score did not significantly improve, from -0.89 (range, -3.00 to 0.67) at enrollment to -0.59 (range, -3.66 to 2.24).
  
  
  CONCLUSIONS
  The nutritional status of children with EoE was mildly affected and not worsened by the 2-month dietary therapy.
authors.affiliation: Hôpital Necker - Enfants Malades, Université Paris Descartes, Paris, France; Nutricia Nutrition Clinique, Saint-Ouen, France.
authors.forename: Diana
authors.initials: D
authors.lastname: Colson
authors.affiliation: Hôpital Necker - Enfants Malades, Université Paris Descartes, Paris, France; Clinique Pédiatrique Saint Antoine, Hôpital Saint Vincent de Paul, Groupement des Hôpitaux de l'Institut Catholique de Lille, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Kalach
authors.affiliation: Hôpital Necker - Enfants Malades, Université Paris Descartes, Paris, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Soulaines
authors.affiliation: Cabinet de pédiatrie, Boulogne, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Vannerom
authors.affiliation: Hôpital Necker - Enfants Malades, Université Paris Descartes, Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Campeotto
authors.affiliation: Hôpital Necker - Enfants Malades, Université Paris Descartes, Paris, France.
authors.forename: Cecile
authors.initials: C
authors.lastname: Talbotec
authors.affiliation: Hôpital Necker - Enfants Malades, Université Paris Descartes, Paris, France; Laboratoire d'Immunologie Biologie, Hôpital Necker - Enfants Malades, Paris, France.
authors.forename: Lucienne
authors.initials: L
authors.lastname: Chatenoud
authors.affiliation: INSERM 1069, CHRU Tours, F-37000, Tours; Univ. F. Rabelais, Tours. France.
authors.forename: Régis
authors.initials: R
authors.lastname: Hankard
authors.affiliation: Hôpital Necker - Enfants Malades, Université Paris Descartes, Paris, France; Clinique Pédiatrique Saint Antoine, Hôpital Saint Vincent de Paul, Groupement des Hôpitaux de l'Institut Catholique de Lille, France. Electronic address: christophe.dupont@nck.aphp.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Dupont
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D057765:Eosinophilic Esophagitis / Q000178:diet therapy* / Q000473:pathology; D004947:Esophagus / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D009752:Nutritional Status; D012189:Retrospective Studies; D012882:Skin Tests
keywords: Dietary therapy; Eosinophilic esophagitis; Nutritional status