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Clinical, histopathological features and efficacy of elimination diet and proton-pump inhibitor therapy in achieving histological remission in Asian children with eosinophilic gastritis.
- Source :
-
Journal of paediatrics and child health [J Paediatr Child Health] 2022 Jul; Vol. 58 (7), pp. 1244-1250. Date of Electronic Publication: 2022 Apr 07. - Publication Year :
- 2022
-
Abstract
- Aim: Paediatric eosinophilic gastritis (EG) is a rare disorder and existing literature on diagnostic criteria and management remains lacking. We aim to describe the clinical spectrum and assess the efficacy of dietary elimination and proton-pump inhibitor (PPI) therapy, with particular emphasis on histologic remission in children with primary EG.<br />Methods: We performed a retrospective study of patients aged 0-18 years diagnosed with EG at a single centre in Singapore from 2013 to 2021. EG was diagnosed based on histological criteria of infiltration of >30 eosinophils per high-power film (HPF) in >5 separate HPFs from gastric biopsies, in the absence of other causes. First-line treatment consisted of PPI therapy and empiric 1-6 food elimination diet (FED). Outcomes measured were clinical, endoscopic and histological remission (defined as eosinophil count <20/HPF in gastric biopsies).<br />Results: Twenty-one (66.7% females) patients were included with median age at diagnosis of 15 months (range:3-192). Majority presented with vomiting (76.2%) and gastrointestinal bleeding (71.4%). Twenty patients were initiated on FED+PPI and 16 had post-treatment biopsies. Clinical, endoscopic and histologic remissions were achieved in 94.7%, 81.3% and 68.8% respectively following FED+PPI. Histologic remission was significantly associated with younger age (9 vs. 132 months; P = 0.026). Four patients who did not respond to FED+PPI were started on oral viscous budesonide, of whom one achieved histological remission and two had clinical improvement.<br />Conclusions: FED+PPI is effective as first-line treatment in achieving histological remission in paediatric EG particularly in younger patients. Topical corticosteroids can be considered for those who have failed FED+PPI therapy.<br /> (© 2022 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)
Details
- Language :
- English
- ISSN :
- 1440-1754
- Volume :
- 58
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of paediatrics and child health
- Publication Type :
- Academic Journal
- Accession number :
- 35388934
- Full Text :
- https://doi.org/10.1111/jpc.15969