Celiac Disease and Eosinophilic Esophagitis: A True Association

Abstract

The prevalence of EE in this cohort of children with CD is at least 4%. This is likely to be an underestimation because only 121 of 250 children had concurrent esophageal biopsies. Coexistent EE should be kept in mind in children undergoing endoscopy for suspected CD, and esophageal biopsies should be obtained, irrespective of whether esophageal mucosa appears normal or abnormal at endoscopy.

Çölyak hastalığı ve eozinofilik özefajit birlikteliği: Bu iki hastalık için bir tesadüf mü?

“…Ooi et al (1) reported the prevalence of EE to be 3.2% among 221 children with CD. Leslie et al (2) reported the prevalence of EE to be 4% among 250 children with CD and in this study 3 of 10 children were reported to have symptoms of CD and EE, esophagus appeared normal at endoscopy, but biopsies showed evidence of EE similar to our case. Another study showed that approximately 30% of children diagnosed as having EE had normal-appearing esophageal mucosa at endoscopy (6).…”

“…Our patient presented with only abdominal pain and constipation. Leslie et al (2) reported that 1 of 10 children with CD and EE presented with only abdominal pain and normal-appearing esophageal mucosa at endoscopy but biopsies showed evidence of EE, as in our case. However, other diseas that are associated with esophageal eosinophilia were also excluded for our patient with clinical and laboratory findings.…”

“…The effect of a gluten-free diet on EE in children with both CD and EE is varied in the reported studies. In two studies, children who had undergone repeated endoscopic examinations showed recovery of their duodenal mucosa but no resolution of esophageal eosinophilia on a gluten-free diet alone, as in our case (1,2). However, Quaglietta et al (7) reported that 6 children with CD and EE who primarily had the symptoms of EE had all improved symptomatically on gluten-free diet, and 3 children's second endoscopy showed significant reduction in intraesophageal eosinophils.…”

“…It is a rare case in the literature of children who underwent upper gastrointestinal endoscopy for suspected CD, which was confirmed histologically, were also found to have endoscopic and histological evidence of EE. Recent case reports and cohort studies have suggested an association between CD and EE in pediatric populations (1,2). This case report aims to make a contribution to the literature by showing the rare co-existence of the two diseases.…”

Non-IgE Medicated Food Allergy: Eosinophilic Esophagitis Update on the Pathogenesis, Clinical Features, and Management of Eosinophilic Esophagitis in Children

“…It is important, however, to understand that primary EoE may co-exist with at least some of these disorders. For example, treatment of celiac disease with a gluten-free diet will result in concomitant resolution of EoE in \50 % of cases [4]. Symptoms in EoE are broad, often overlap with other diseases, and can vary based on age.…”