Eosinophilic Esophagitis in Children and Adolescents with Abdominal Pain: Comparison with EoE-Dysphagia and Functional Abdominal Pain.
Aim. Compare EoE-AP with EoE-D for clinical, endoscopy (EGD), histology and outcomes and also with FAP-N. Method. Symptoms, physical findings, EGD, histology, symptom scores, and treatments were recorded for the three groups. Cluster analysis was done. Results. Dysphagia and abdominal pain were different in numbers but not statistically significant between EoE-AP and EoE-D. EGD, linear furrows, white exudates were more in the EoE-D and both combined were significant (p < 0.05). EoE-D, peak and mean eosinophils (p  0.06) and eosinophilic micro abscesses (p  0.001) were higher. Follow-Up. Based on single symptom, EoE-AP had 30% (p  0.25) improvement, EoE-D 86% (p < 0.001) and similar with composite score (p  0.57 and <0.001, resp.). Patients who had follow-up, EGD: 42.8% with EoE-AP and 77.8% with EoE-D, showed single symptom improvement and the eosinophil count fell from 38.5/34.6 (peak and mean) to 31.2/30.4 (p  0.70) and from 43.6/40.8 to 25.2/22.8 (p < 0.001), respectively. FAP-N patients had similar symptom improvement like EoE-D. Cluster Analysis. EoE-AP and FAP-N were similar in clinical features and response to treatment, but EoE-D was distinctly different from EoE-AP and FAP-N. Conclusion. Our study demonstrates that EoE-AP and EoE-D have different histology and outcomes. In addition, EoE-AP has clinical features similar to the FAP-N group.
Advocate Children's Hospital, University of Illinois and Loyola Medical Center, 1775 Dempster Street, Park Ridge, IL 60068, USA.
Thirumazhisai
0000-0002-9314-8535
T
Gunasekaran
Advocate Children's Hospital, 1775 Dempster Street, Park Ridge, IL 60068, USA.
Gautham
0000-0002-6931-5292
G
Prabhakar
University of Illinois, Chicago, IL 60607, USA.
Alan
0000-0003-3809-6637
A
Schwartz
Advocate Children's Hospital, 1775 Dempster Street, Park Ridge, IL 60068, USA.
Kiranmai
K
Gorla
University of Indiana, Indianapolis, IN 46202, USA.
Sandeep
S
Gupta
Advocate Children's Hospital and Loyola Medical Center, 1775 Dempster Street, Park Ridge, IL 60068, USA.
James
0000-0001-7884-1844
J
Berman
D015746:Abdominal Pain / Q000097:blood / Q000209:etiology / Q000473:pathology*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003680:Deglutition Disorders / Q000097:blood / Q000209:etiology / Q000473:pathology*; D057765:Eosinophilic Esophagitis / Q000097:blood / Q000150:complications / Q000473:pathology*; D004804:Eosinophils; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index