Eosinophilic Esophagitis in Brazilian Pediatric Patients

Pinheiro, Mayra Isabel Correia; Cavalcanti, Luciano Pamplona de Góes; Honório, Rodrigo Schuler; Moreno, Luís Hélder de Alencar; Fortes, Mayara Carvalho; Silva, Carlos Antônio Bruno da

doi:10.4137/cmped.s12733

Cited by 12 publications

(16 citation statements)

References 22 publications

(36 reference statements)

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“…The frequency, incidence, and prevalence of EsEo are not well studied, the majority data around EsEo is derived from EoE studies which show highly variable data dependent on both the study design and the population studied. In the current study, we found an EsEo frequency of 5.2% among the children examined, and this frequency is within the range observed worldwide when deriving the data from scientific reports on EoE, considering that EsEo is a histological marker for EoE diagnosis 16 . Moreover, the frequency of EsEo with ages between 0–18 years varies for patients undergoing upper digestive endoscopy.…”

Section: Discussionsupporting

confidence: 86%

Frequency of Esophageal Eosinophilia in a Pediatric Population from Central Brazil

Strozzi

Botacin

Mekdessi

et al. 2018

Sci Rep

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Here we report a retrospective cross-sectional study on Esophageal eosinophilia (EsEo) frequency in Brazil, for 2, 425 pediatric patients with symptoms associated with gastroesophageal diseases in 2012. EsEo is defined by ≥15 eosinophils per high power field (400x) and confirmed through histological analyses of esophageal biopsies. Overall, 126 patients had EsEo equating to a frequency of 5.2%. There was a significant difference between the endoscopic features of patients with EsEo, where 10.7% had erosive esophagitis, 3.0% had non-erosive esophagitis and 1% showed normal esophageal mucosa. According to the interaction of the variables in the Classification and Regression Tree Analysis, most patients diagnosed with EsEo were older males with erosive esophagitis. On the other hand, the lowest frequency of EsEo was found among younger females with non-erosive esophagitis/normal mucosa. Environmental conditions, including climate variation and changes, were observed in association with EsEo, supporting a potential role for environmental factors in its pathogenesis. There was an inverse correlation between the number of EsEo, rainfall and humidity. EsEo is a relatively frequent finding in the pediatric population of Brazil with symptoms of gastroesophageal diseases. Both clinical and histological examinations of patients are important for a reliable diagnostic of EsEo cases and to patient care.

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Section: Discussionsupporting

confidence: 86%

Frequency of Esophageal Eosinophilia in a Pediatric Population from Central Brazil

Strozzi

Botacin

Mekdessi

et al. 2018

Sci Rep

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“…In our meta‐analysis, the studies included came from several countries in different parts of Europe and North America, along with an additional study from Australia. It should be noted that population‐based data on the epidemiology of EoE is scarce to non‐existent from regions, where EoE has only recently started to be diagnosed, including Central and South America, Asia, and Northern Africa …”

Section: Discussionmentioning

confidence: 99%

Systematic review with meta‐analysis: the incidence and prevalence of eosinophilic oesophagitis in children and adults in population‐based studies

Arias¹,

Pérez-Martínez

Tenías³

et al. 2015

Aliment Pharmacol Ther

264

161

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“…The most intense eosinophilic infiltrate was seen in the distal esophagus, as reported by other authors (10,20) . Pinheiro et al (19) reported a series of 11 patients with EoE, all of them presenting more than 30 eosinophils/hpf in distal esophagus. The more intense infiltrate observed by those authors may be a consequence of different inclusion criteria (12) .…”

Section: Discussionmentioning

confidence: 99%

Histological Features of Eosinophilic Esophagitis in Children and Adolescents

Carrasco

Machado

Patrı́cio

et al. 2017

Arq. Gastroenterol.

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-Background -Eosinophilic esophagitis is an emerging disease featured by eosinophilic esophageal infiltrate not responsive to proton pump inhibitors. Objective -To characterize histological features of children and adolescents with eosinophilic esophagitis. Methods -Cross-sectional study in a tertiary hospital. Biopsies from each esophageal third from 14 patients (median age 7 years) with eosinophilic esophagitis were evaluated. Histological features evaluated included morphometry of esophageal epithelium, esophageal density (per high power field), extracellular eosinophilic granules, eosinophilic microabscesses, surface disposition of eosinophils, epithelial desquamation, peripapillary eosinophilia, basal layer hyperplasia and papillary elongation. Results -Several patients presented a normal esophageal macroscopy in the upper digestive endoscopy (6, 42.8%), and the most common abnormality were vertical lines (7, 50%) and whitish spots over esophageal mucosa (7, 50%). Basal layer hyperplasia was observed in 88.8%, 100% e 80% of biopsies from proximal, middle and lower esophagus, respectively (P=0.22). Esophageal density ranges from 0 to more than 50 per hpf. Extracellular eosinophilic granules (70%-100%), surface disposition of eosinophils (60%-93%), epithelial desquamation (60%-100%), peripapillary eosinophilia (70%-80%) were common, but evenly distributed among each esophageal third. Just one patient did not present eosinophils in the lower third, four in the middle third and four in the upper esophageal third. Conclusion -In the absence of hypereosinophilia, other histological features are present in eosinophilic esophagitis and may contribute to diagnosis. Eosinophilic infiltrate is focal, therefore multiple biopsies are needed for diagnosis.

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Eosinophilic Esophagitis in Brazilian Pediatric Patients

Cited by 12 publications

References 22 publications

Frequency of Esophageal Eosinophilia in a Pediatric Population from Central Brazil

Frequency of Esophageal Eosinophilia in a Pediatric Population from Central Brazil

Systematic review with meta‐analysis: the incidence and prevalence of eosinophilic oesophagitis in children and adults in population‐based studies

Histological Features of Eosinophilic Esophagitis in Children and Adolescents

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