Eosinophilic esophagitis after esophageal atresia: is there an association? Case presentation and literature review

Gorter, Ramon R.; Heij, Hugo A.; Voorn, J. Patrick van der; Kneepkens, C. M. F.

doi:10.1016/j.jpedsurg.2012.01.079

Cited by 29 publications

(55 citation statements)

References 35 publications

(44 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3,6,21 The above mentioned observations suggest that EoE should be taken into consideration when making a differential diagnosis in patients with EA who have dysphagia and refractory gastroesophageal reflux symptoms before considering anti-reflux surgery. 3,21 The age of onset of EoE and EA ranges from 18 months to 12.5 years, and this entity is more common among men, except for the study by Dhaliwal et al, where it was predominant among women (1.6:1). In relation to the clinical presentation, this study found a significantly higher incidence of GERD symptoms, such as vomiting and dysphagia, among patients with EoE compared to those without EoE.…”

Section: Esophageal Atresia and Eosinophilic Esophagitismentioning

confidence: 99%

“…EoE may affect all age groups but it is more common among men (3:1) and Caucasians, and it occurs in 8-10% of children with suspected anti-reflux-refractory GERD. 3,9 EoE is believed to be a Th2 cell-mediated entity triggered by food and/or environmental antigens. There is an increase in interleukin (IL)-5 and IL-13, which are responsible for eosinophil differentiation and maturation, and for stimulating the esophageal epithelium to produce eotaxin-3, that recruits eosinophils.…”

Section: Eosinophilic Esophagitismentioning

confidence: 99%

“…Gorter et al have proposed that mutations in the FOX gene not only cause congenital malformations in the esophagus and lung but may also predispose to EoE, so patients with EA may be at a high risk for EoE. 3,6,21 The above mentioned observations suggest that EoE should be taken into consideration when making a differential diagnosis in patients with EA who have dysphagia and refractory gastroesophageal reflux symptoms before considering anti-reflux surgery. 3,21 The age of onset of EoE and EA ranges from 18 months to 12.5 years, and this entity is more common among men, except for the study by Dhaliwal et al, where it was predominant among women (1.6:1).…”

Section: Esophageal Atresia and Eosinophilic Esophagitismentioning

confidence: 99%

“…The treatment of choice is surgical repair with potential late complications such as dysphagia, gastroesophageal reflux, strictures, and dysmotility. [3][4][5] An increased risk of EoE has been described in patients with successful repair of EA secondary to gastroesophageal reflux disease (GERD), esophageal dysmotility, and the genetic similarities common to both conditions: the mutations in the Forkhead box (FOX) gene cause congenital anomalies, such as EA. In addition, FOXF1 genes are present in the promoter region of inflammation, including eotaxin-3, which is increased in EoE; therefore, Gorter et al proposed that patients with EA may have a greater risk for developing EoE.…”

Section: Introductionmentioning

confidence: 99%

“…Based on the above, EoE should be considered when making a differential diagnosis in children with repaired EA who have recurrent strictures, persistent dysphagia, and refractory symptoms related to gastroesophageal reflux. 3,6 …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Eosinophilic esophagitis and esophageal atresia: coincidence or causality?

Salgado

Rocca

2018

Arch Argent Pediatr

View full text Add to dashboard Cite

Eosinophilic esophagitis is an immune-mediated chronic disease of the esophagus characterized by symptoms related to esophageal dysfunction and tissue eosinophilia. In the endoscopy, the esophageal mucosa may appear normal or show exudates, rings, edema, furrows, and strictures. Its management is based on elimination diet, topical corticosteroids and/or esophageal dilation. Atresia is the most common congenital alteration of the esophagus; it requires surgical repair and poses potential complications, such as gastroesophageal reflux, strictures, and esophageal dysmotility. Up to 2015, 48 cases of eosinophilic esophagitis and esophageal atresia were reported, with dysmotility, reflux, and long-term acid suppression involvement. Prevalent clinical signs include dysphagia, difficulty eating, and reflux symptoms, so an esophagogastroduodenoscopy with biopsy is recommended to rule out associated eosinophilic esophagitis in patients with esophageal atresia and persistent symptoms before performing an esophageal dilation and/or anti-reflux surgery. If eosinophilic esophagitis is confirmed, it should be managed with the corresponding drugs, and the subsequent therapeutic approach will depend on its clinical course.

show abstract

Section: Esophageal Atresia and Eosinophilic Esophagitismentioning

confidence: 99%

Section: Eosinophilic Esophagitismentioning

confidence: 99%

Section: Esophageal Atresia and Eosinophilic Esophagitismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Eosinophilic esophagitis and esophageal atresia: coincidence or causality?

Salgado

Rocca

2018

Arch Argent Pediatr

View full text Add to dashboard Cite

show abstract

The use of amino acid‐based nutritional feeds is effective in the dietary management of pediatric eosinophilic oesophagitis

Atwal

Hubbard

Venter

et al. 2019

Immunity Inflam & Disease

View full text Add to dashboard Cite

Introduction Eosinophilic oesophagitis (EoE) is an immune‐mediated, chronic disease characterized by eosinophilic inflammation and esophageal dysfunction. Specific food allergens including cow's milk protein, are partially causative to disease progression, and dietary management forms three main options; the elemental diet (ED), the empirical elimination diet (EED), and the targeted elimination diet (TED). The dietary choice should be individualized, however, the European Society for Pediatric Gastroenterology, Hepatology and Nutrition guidelines recommend an ED for pediatric EoE with multiple food allergies, failure to thrive, unresponsive disease or unable to follow a highly restricted diet. The aim of this narrative review was to explore the effectiveness of the ED (using amino acid formula [AAF]), in the management of pediatric EoE. Methods Literature searches were performed to identify eligible studies that described outcomes including eosinophil count, clinical symptoms, growth, and medications. Results Overall, 10 eligible studies were found, with n = 462 patients assigned to receive AAF from a total of n = 748 (average age 6.7 years), for a duration of 4 to 8 weeks. The use of AAF reduced eosinophil levels and demonstrated remission (defined as ≤10 eosinophils per high power field) in 75%‐100% of children with improvements, if not resolution, in clinical symptoms. AAF was more clinically effective than the use of the EED or TED, where remission rates were 75%‐81% and 40%‐69%, respectively. Few studies collected growth outcomes, however where documented these were positive for those on AAF. The long‐term impacts of each diet were not thoroughly explored. Conclusions The use of AAF is a clinically effective management option for pediatric EoE, and further research is required to guide long‐term management.

show abstract

Eosinophilic esophagitis in children: A cross‐sectional study from a tertiary care center

Samanta,

Poddar,

Kumari

et al. 2023

JGH Open

View full text Add to dashboard Cite

Background and AimThe prevalence of eosinophilic esophagitis (EoE) is rising in the West. However, data from the Indian subcontinent is limited. In this prospective cross‐sectional study, we estimated the prevalence of EoE among children undergoing elective upper gastrointestinal endoscopy (UGIE).MethodsWe enrolled 200 consecutive children (123 boys, median age 10.25 years [interquartile range 8.25–14.5]) between March 2020 and November 2022 at our center. Clinical characteristics, endoscopic findings, and laboratory parameters were noted. A total of 12 mucosal biopsies (3 each from the middle and lower third of the esophagus, stomach, and duodenum) were obtained. EoE was diagnosed if the peak eosinophil count was ≥15/high‐power field (HPF) in absence of gastric and duodenal eosinophilia.ResultsThe commonest indications for UGIE were gastroesophageal reflux disease‐like symptoms (29%), inflammatory bowel disease (22.5%), celiac disease (15%), and abdominal pain (13%). EoE was detected in seven children, suggesting an overall prevalence of 3.5%. Of the 20 children evaluated for dysphagia, 4 (20%) had EoE. Also, two of three (67%) children presented with food bolus impaction along with dysphagia had EoE. Of the seven children with EoE, three (43%) had bronchial asthma, two (28.5%) had peripheral eosinophilia, and one (14%) had elevated serum IgE. Trachealization and linear furrows were found in 57% and 71% cases, respectively. Four children received high‐dose proton pump inhibitor (PPI) for 12 weeks, two received PPI+ stricture dilatation, and one received systemic steroids. All achieved clinical, endoscopic, and histopathological remission.ConclusionHospital‐based prevalence of EoE among children undergoing elective UGIE was 3.5%. EoE patients had favorable outcomes with PPI.

show abstract

Eosinophilic esophagitis after esophageal atresia: is there an association? Case presentation and literature review

Cited by 29 publications

References 35 publications

Eosinophilic esophagitis and esophageal atresia: coincidence or causality?

Eosinophilic esophagitis and esophageal atresia: coincidence or causality?

The use of amino acid‐based nutritional feeds is effective in the dietary management of pediatric eosinophilic oesophagitis

Eosinophilic esophagitis in children: A cross‐sectional study from a tertiary care center

Contact Info

Product

Resources

About