1. Characterization of Eosinophilic Esophagitis From the European Pediatric Eosinophilic Esophagitis Registry (pEEr) of ESPGHAN.
- Author
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Oliva S, Dias JA, Rea F, Malamisura M, Espinheira MC, Papadopoulou A, Koutri E, Rossetti D, Orel R, Homan M, Bauraind O, Auth MK, Junquera CG, Vande Velde S, Kori M, Huysentruyt K, Urbonas V, Roma E, Fernández SF, Domínguez-Ortega G, Zifman E, Kafritsa P, Miele E, and Zevit N
- Subjects
- Adolescent, Child, Child, Preschool, Delayed Diagnosis, Endoscopy, Gastrointestinal, Enteritis, Eosinophilia, Female, Gastritis, Humans, Male, Proton Pump Inhibitors therapeutic use, Registries, Deglutition Disorders drug therapy, Deglutition Disorders etiology, Eosinophilic Esophagitis complications, Eosinophilic Esophagitis diagnosis, Eosinophilic Esophagitis epidemiology, Food Hypersensitivity
- Abstract
Objectives: Few pediatric data on phenotypic aspects of eosinophilic esophagitis (EoE) are available. The pEEr registry was developed to prospectively characterize children with EoE from Europe and Israel., Methods: pEEr is an ongoing prospective registry enrolling children with esophageal eosinophilia (≥15 eos/HPF). Anonymized data were collected from 19 pediatric centers. Data regarding demographics, clinical manifestations, endoscopy, histology, and therapies were collected., Results: A total of 582 subjects (61% male) were analyzed. The median age at diagnosis was 10.5 years [interquartile range (IQR): 5.7-17.7], whereas the age at symptom onset was 9.2 years (IQR: 4.3-16.4), resulting in a median diagnostic delay of 1.2 years (IQR: 0.7-2.3). The diagnostic delay was longer below age <6 years. Shorter diagnostic delays were associated with the presence of food allergy or a family history for EoE. Symptoms varied by age with dysphagia and food impaction more common in adolescents, while vomiting and failure to thrive more common in younger children ( P < 0.001). Among endoscopic findings, esophageal rings were more common in adolescents, whereas exudates were more frequent in younger children( P < 0.001). Patients who responded to proton pump inhibitors (PPIs) were more likely to be older, males, and less often presented severe endoscopic findings. Patients unresponsive to PPIs received topical steroids (40%), elimination diet (41%), or a combined therapy (19%)., Conclusions: EoE findings vary according to age in pediatric EoE. Young children are commonly characterized by non-specific symptoms, atopic dermatitis, food allergy, and inflammatory endoscopic lesions. Adolescents usually have dysphagia or food impaction, fibrostenotic lesions, and a better PPI response., Competing Interests: Noam Zevit: consultation fees – Dr Falk Pharma, Adare Pharmaceuticals; speaker fees – Rafa inc and Sanofi. Salvatore Oliva: consultation fees – Medtronic, Ocean Farma; speaker fees – Medtronic. Marcus Karl-Heinz Auth – consultation fees: Dr Falk Pharma; educational grants: Nutricia, Mead Johnson. Alexandra Papadopoulou: research grants from Abbvie, United Pharmaceuticals, Dr Falk Pharma GmbH, Takeda, AstraZeneca; speaker or consultation fees from Adare Pharmaceuticals, Dr Falk Pharma GmbH, Specialty Therapeutics, Uni-Pharma Pharmaceuticals Laboratories S.A., Cross Pharmaceuticals, Petsiavas, Nestle, Touch Independent Medical Education, and Sanofi-Aventis. The remaining authors report no conflicts of interest., (Copyright © 2022 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
- Published
- 2022
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