Pediatric patients experience higher eosinophilic esophagitis endoscopic findings
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Compared with adult patients who more frequently experienced delayed eosinophilic esophagitis diagnosis, pediatric patients had higher endoscopic findings of the disease with increased eosinophils detected during esophageal biopsy.
“Incidence and prevalence of EoE has sharply increased in the last few years. Currently, EoE is the most frequent eosinophilic gastrointestinal disorder with a diagnosis peak for patients between 20 and 40 years old,” Emilio Jose Laserna-Mendieta, PhD, MSc, of the department of gastroenterology at the Hospital General de Tomelloso in Tomelloso, Spain, said at UEG Week.
“Although previous descriptions of patients indicate that some differences could exist in endoscopic features and clinical presentation between childhood onset and adulthood onset EoE, there are no cohort studies combining both groups,” continued Laserna-Mendieta, who also works in laboratory medicine at the Hospital Universitario La Princesa and at the Instituto de Investigación Sanitaria La Princesa, both in Madrid, Spain.
To compare disease characteristics between childhood-onset vs. adulthood-onset EoE, researchers gathered clinical, histologic, endoscopic and therapeutic data from the multicenter EoE CONNECT registry which comprised 22 hospitals across Europe. Among 1,003 patients with EoE, diagnosis occurred in 816 patients during adulthood and 187 patients during childhood or adolescence.
According to investigation, adults experienced a longer diagnostic delay compared with children (median 2.4 years vs. median 1 year; P < 0.001) and more frequently experienced a stricturing EoE phenotype (13.7% vs. 8.2%; P = 0.01). Conversely, endoscopic findings suggested EoE was found more frequently among children and associated with higher peak eosinophil counts during esophageal biopsies (50 vs. 40; P = 0.038). Further analysis revealed swallowable topic corticosteroids (13.3% vs. 7.7%) and dietary therapy (12% vs. 6.5%) were more common among children while proton pump inhibitors were more common among adults (85.8% vs. 74.7%). There were no observed differences between groups for gender distribution (males: 75.7% vs. 79.7%), birthweight and presence of allergy symptoms.
“The factors determining these differences between groups warrant further research,” Laserna-Mendieta concluded.
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Laserna-Mendieta EJ, et al. Abstract OP176. Presented at: UEG Week; Oct. 3-5, 2021 (virtual meeting).
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