114 / 5.000 Eosinophilic esophagitis in children: is it on the rise? Characterization in 2 specialized pediatric care centers

Abstract

INTRODUCTION: Eosinophilic esophagitis, a chronic immune-mediated disease characterized by eosinophilic infiltration of the epithelium, symptoms of esophageal dysfunction, requires endoscopy with biopsies for definitive diagnosis. Recent reports speak of a worldwide increase. OBJECTIVE: Characterization of Eosinophilic Esophagitis in 2 specialized pediatric centers, one public (Hospital de Niños JM De Los Ríos) and one private in the last 20 years (2003-2023). METHODS: Retrospective, descriptive and longitudinal study, database review, determination of differences in frequency, age, sex, symptoms, endoscopic and histopathological findings. OpenEpi software, descriptive statistics, t-student test and Chi-Square test were used. RESULTS: 27 patients with endoscopic findings suggestive of Eosinophilic Esophagitis, 15/27 (4 public center and 11 private center) presented histopathological diagnosis. Male sex predominated (73.3%), adolescents 3/4 in public centers and preschoolers 8/11 in private centers (significant difference p 0.028). Endoscopic findings were predominantly furrows and squared appearance 8/11 in the private center and whitish exudates followed by rings 2/4 respectively, in the public center. Presentation with clinical presentation of GER and dysphagia to solids predominated in the public center and vomiting followed by dysphagia to solids in the private center. 86% of cases were diagnosed between 2010-2014.  CONCLUSION: Eosinophilic esophagitis is infrequent in children; we observed a higher frequency of cases in younger children in private centers and adolescents in public centers. Presentation with general symptoms such as vomiting in young children as opposed to dysphagia and food impaction, main symptoms in adolescents and adults, may delay suspicion and diagnosis at early ages. There has been no increase in the number of cases in recent years.