title: [Eosinophilic esophagitis in children: Evaluation of practices through a multicenter study].
abstract: Eosinophilic esophagitis (EE) is a recent pathology defined by abnormal immune response of the esophageal mucosa to exogenous allergens, leading to chronic mucosa infiltration by 15 eosinophils per High-Power-Field (Eos/HPF). The present retrospective study was designed to assess the hospital care for children suffering from EE in several hospitals in western France in order to highlight discrepancies and improve future care. Twenty-eight children ranging from 1.5 months to 17 years old were included in the study. Episodes of food blockage were the most frequently reported symptoms (46 %). A ratio of 29 % of EE patients reported macroscopically normal endoscopy; diagnosis was then established upon histological anomalies found in biopsies. The mean eosinophil count was 72.4 Eos/HPF. Centralized immunohistochemical staining revealed the presence of IgG4-responding plasma cells in 76.5 % of patients, as well as IgG4 intraepithelial degranulation in 14 % of them. The evaluation of the treatment plan showed important inter-center discrepancies with only 43 % of patients receiving endoscopic reevaluation. This study objectively highlights heterogeneities in diagnosis and care provided to children suffering from EE. Therefore, improving the consistency of practices seems to be crucial to optimize the patients' outcome. The role of IgG4 as a new diagnosis marker remains to be clarified.
authors.affiliation: Service de pédiatrie, CHU hôpital Sud, 16, boulevard de Bulgarie, 35000 Rennes, France. Electronic address: clementine.vigier@live.fr.
authors.forename: C
authors.initials: C
authors.lastname: Vigier
authors.affiliation: Service d'anatomie et cytologie pathologiques, CHU Pontchaillou, 2, rue Henri-le-Guilloux, 35000 Rennes, France.
authors.forename: S
authors.initials: S
authors.lastname: Henno
authors.affiliation: Service de pédiatrie, CHU hôpital Clocheville, 49, boulevard Béranger, 37000 Tours, France.
authors.forename: S
authors.initials: S
authors.lastname: Willot
authors.affiliation: Service d'anatomie et cytologie pathologiques, CHRU hôpital Bretonneau, 2, boulevard Tonnellé, 37000 Tours, France.
authors.forename: M C
authors.initials: MC
authors.lastname: Machet
authors.affiliation: Service de pédiatrie, centre hospitalier Bretagne Atlantique, 20, boulevard Général-Maurice-Guillaudot, 20, boulevard Général-Maurice-Guillaudot, 56000 Vannes, France.
authors.forename: B
authors.initials: B
authors.lastname: Cagnard
authors.affiliation: Service de pédiatrie, centre hospitalier Yves-Le-Foll, 10, rue Marcel-Proust, 22000 Saint-Brieuc, France.
authors.forename: E
authors.initials: E
authors.lastname: Breton
authors.affiliation: Service de pédiatrie, CHU d'Angers, 4, rue Larrey, 49100 Angers, France.
authors.forename: E
authors.initials: E
authors.lastname: Chaillou
authors.affiliation: Service de pédiatrie, CHU hôpital Sud, 16, boulevard de Bulgarie, 35000 Rennes, France.
authors.forename: A
authors.initials: A
authors.lastname: Dabadie
authors.affiliation: Service de pneumologie, CHU Pontchaillou, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors.forename: C
authors.initials: C
authors.lastname: Rochefort-Morel
authors.affiliation: Service de pédiatrie, CHU hôpital Sud, 16, boulevard de Bulgarie, 35000 Rennes, France.
authors.forename: L
authors.initials: L
authors.lastname: Bridoux-Henno
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D057765:Eosinophilic Esophagitis / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D004804:Eosinophils / Q000276:immunology / Q000473:pathology; D000071041:Esophageal Mucosa / Q000276:immunology / Q000473:pathology; D005260:Female; D005602:France; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D012189:Retrospective Studies