BACKGROUND: Vitamin D is an essential fat-soluble steroid hormone and vitamin D deficiency is a global public health problem especially among children and adolescents. Factors such as the low intake of vitamin D-rich food sources, poor absorption and less exposure to the sun influence this outcome. Vitamin D has an anti-inflammatory effect in the body by promoting regulatory T cell differentiation as well as recovering T helper 17 cell response and secretion of anti-inflammatory cytokines. Eosinophilic esophagitis (EoE) is a chronic disease, histologically characterized by predominantly eosinophilic inflammation. The most common therapeutic approaches are allergen-eliminating diets, such as excluding cow’s milk, egg, soy, wheat, peanuts and seafood, or more specific dietary restrictions. OBJECTIVE: To verify the serum levels of vitamin D in children and adolescents with eosinophilic esophagitis on a restricted food diet and to analyze their association with nutritional status, consumption of different food sources, exposure to the sun and skin color. METHODS: Case-control study conducted in the city of Campinas-SP, Brazil, in which included patients were aged 2 to 18 years old, and those diagnosed with eosinophilic esophagitis was referred to as the case group (n=15), meanwhile a control group (n=17) was also formed. Epidemiological data, nutritional status, data on vitamin D intake (24-hour recall - performed only by EoE patients - and self-reported intake of vitamin D food sources: milk and dairy products, canned tuna and sardines, Bull’s liver, chicken eggs - applied in both groups), and daily time of sun exposure (≥30 min or ≤30 min) were recorded. The samples were collected for serum levels of 25-hydroxy-vitamin D, where sufficiency levels >30 ng/mL were considered, insufficiency 21 to 30 ng/mL, deficiency <20 ng/mL. RESULTS: There was a higher frequency of vitamin D insufficiency/ deficiency in the Eosinophilic Esophagitis group (P=0.035), even with longer sun exposure (P= 0.035). Skin color was not associated with lower levels of vitamin D in both groups studied. No difference was found in nutritional status between the groups. CONCLUSION: The present study demonstrated a higher frequency of inadequate/ deficient levels of vitamin D in children and adolescents with EoE on a restricted diet. When necessary, serum levels should be investigated and correct exposure to the sun should be encouraged, with special attention to the recommended guidelines, time spent in the sun and the appropriate clothing for correct absorption. Since exposure for more than 30 minutes in the sun does not appear to have provided a protective effect in the EoE group, even in a region with high levels of solar radiation. There was a significant difference only in the consumption of cow’s milk between the case and control groups, demonstrating the low adherence to the restriction diet by the case group. No association was found between serum 25 hydroxyvitamin D levels and nutritional status. Moreover, no association regarding the adequate or inadequate status of 25 hydroxyvitamin D and the consumption vitamin D-rich foods was identified. Multicentered studies with a larger number of cases should be performed to assess serum 25 hydroxyvitamin D levels and associated factors in pediatric patients with EoE.
RATIONALE: Eosinophilic Esophagitis (EoE) is a condition with an increasing frequency, i ts relevant studying natural evolution of allergic diseases, considering EoE as a part of these conditions METHODS: We performed a retrospective analysis of 71 EoE patients. The objective was to describe the frequency of atopies and IgE mediated food allergy. We evaluated demographics, EoE family history, symptoms onset, diagnosis age, IgE aeroallergen and food sensitization RESULTS: We found diagnosis mean of age was 18 yo (5-78 yo). Time between symptoms onset and EoE diagnosis was 2.86 years. We found male predominance 48/71 (67.70%). The most prevalent atopy was allergic rhinitis (49/71-69.01%), IgE-mediated food allergy (39/71-54.92%), allergic asthma (29/71-40.84%) and atopic dermatitis (12/71-16.90%). Between IgE-mediated food allergy patients, 71.79% presents anaphylaxis history. Eleven patients (15.49%) only have EoE. IgE food sensitization (26/71-36.61%) was more frequent than aeroallergen (5/71-7.04%), being 27 patients (38.02%) with dual IgE sensitization (food and aeroallergen), 26 only food sensitization, 5 only aeroallergen sensitizations. Thirteen patients (18.30%) didn't have any IgE sensitization. About the relationship between food allergy and EoE evolution, found that patients with IgE food reactions preceded the diagnosis of EoE 38/39 (97.43%) CONCLUSIONS: We observed high prevalence of atopic conditions. Food IgE sensitization was important despite most of our patients were adolescents and adults. It's important to follow up food worsening EoE even in older patients. In most cases of IgE mediated food allergies, anaphylaxis history warns us about the possibility that atopic patients that developed EoE could be associated with severe food allergy phenotype RATIONALE: Eosinophilic esophagitis (EoE) is characterized by esophageal dysfunction with eosinophilic inflammation. Severe forms (fibrostenotic) are more frequently described in adults, due to the chronic, progressive evolution of the disease. We analyzed clinical, endoscopic, anatomopathological aspects of children with EoE. METHODS: Retrospective analysis (2001-2017) of 23 children, 0-16 years old (yo), followed-up at a Brazilian teaching hospital. RESULTS: 78,3% boys (n518), 4 yo [1. .83] at the onset of symptoms, 7.46 (SD64.28) yo when diagnosed. Symptoms: abdominal
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.