Clinico-pathological characteristics of children with eosinophilic esophagitis – single-centre experience

Introduction:
The aim of this study was to analyse the clinical picture of children with eosinophilic esophagitis (EoE).

Material and methods:
The medical histories of 45 patients with EoE were retrospectively analysed. Analysis included demographic data, body weight, chronic diseases, family history, occurrence, and duration of symptoms, and endoscopic and histopathological findings.

Results:
The study included 45 children, of whom 60% were boys and 40% girls. The mean age was 10 years (1–17 years). Twenty-eight (62.2%) children had at least one coexisting allergic disease. The co-occurrence of EoE and food allergy was significantly more common in younger children: the median age of patients with EoE and food allergy was 7 years, while the median age of those without food allergy was 12 years. The most common symptoms were eating or feeding difficulties (51.1%). Older children were more likely to have odynophagia, heartburn, dysphagia and abdominal pain. The mean age of children with vomiting was significantly lower than that in children without vomiting. The mean diagnostic delay was 16.3 months (1.4 years). Patients with regurgitation reported a significantly longer median duration of symptoms (21 months) than those without. A significantly shorter diagnostic delay was also noted among children with asthma. The most common type of endoscopic finding was linear oesophageal furrows. The numbers of eosinophils in oesophageal biopsies was in the range 15–100 in the high power field. A higher number of oesophageal eosinophils was noted in patients without chest pain.

Conclusions:
The most common symptoms of EoE were difficulty with food intake, abdominal pain and food impaction. The clinical course varied in children according to age. Children with EoE and co-occurring asthma had a shorter diagnostic delay. The most common feature of EoE on endoscopy was linear oesophageal furrowing. The number of eosinophils in histopathology was not related to the endoscopic result.