Eosinophilic Esophagitis: Association with atopic diseases and IgE mediated Food Allergy

Abstract

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