Eosinophilic esophagitis in pediatric patients – current findings and experience from clinical practice
Authors:
M. Vebr; J. Forejt; J. Sýkora; J. Schwarz
Authors‘ workplace:
Dětská klinika LF UK a FN Plzeň
Published in:
Gastroent Hepatol 2025; 79(6): 450-454
Category:
Pediatric Gastroenterology and Hepatology: Case report
doi:
https://doi.org/10.48095/ccgh2025450
Overview
Eosinophilic esophagitis (EoE) is a chronic, progressive, and immune-mediated disease of the esophagus characterized by a marked infiltration of eosinophils in the mucosa (≥ 15 eosinophils per high-power field in at least one biopsy sample) in the absence of other causes of esophageal eosinophilia. Specific risk factors for the development of the disease are not known; however, male sex, atopy, and a positive family history significantly increase the risk of its occurrence. A personal history often reveals concomitant asthma, allergic rhinitis, atopic dermatitis, or food allergy. The condition may also be drug-induced (e. g., due to oral immunotherapy). Clinical presentation is age-dependent. In infants and young children, symptoms are usually nonspecific – feeding difficulties, vomiting, and failure to thrive. In older children and adolescents, dysphagia, odynophagia, regurgitation, or food impaction in the esophagus are more common. Diagnosis of EoE is based on a combination of clinical presentation, endoscopic findings, and histological examination of biopsy samples. The key diagnostic criterion is demonstration of eosinophilic infiltration of the esophageal mucosa in at least one biopsy specimen. Treatment includes the use of proton pump inhibitors, topical corticosteroids, or implementation of an elimination diet. The aim of this article is to present the issue of this disease in childhood and to publish the experience from our department.
Keywords:
eosinophilic esophagitis – pediatrics – dysphagia
Sources
1. Lucendo AJ, Molina-Infante J, Arias Á et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J 2017; 5 (3): 335–358. doi: 10.1177/2050640616689525.
2. Wiley Online Library. Characterization of eosinophilic esophagitis from the European Pediatric Eosinophilic Esophagitis Registry (pEEr) of ESPGHAN. 2022 [online]. Dostupné z: https: //onlinelibrary.wiley.com/doi/10.1097/MPG.0000000000003530.
3. Melek J, Bělohlávková S, Látalová V et al. Doporučení Sekce dětské gastroenterologie a výživy České pediatrické společnosti pro diagnostiku a léčbu eozinofilní ezofagitidy u dětí. Ces Slov Pediat 2024; 79 (90): 5–28. doi: 10.55095.CSPediatrie2024/061.
4. Hahn JW, Lee K, Shin JI et al. Global incidence and prevalence of eosinophilic esophagitis, 1976–2022: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2023; 21 (13): 3270.e77–3284.e77. doi: 10.1016/j.cgh.2023.06.005.
5. Soon IS, Butzner JD, Kaplan GG et al. Incidence and prevalence of eosinophilic esophagitis in children. J Pediatr Gastroenterol Nutr 2013; 57 (1): 72–80. doi: 10.1097/MPG.0b013e318291 fee2.
6. Kumar S, Choi SS, Gupta SK. Eosinophilic esophagitis: current status and future directions. Pediatr Res 2020; 88 (3): 345–347. doi: 10.1038/s41390-020-0770-4.
7. Robson J, O‘Gorman M, McClain A et al. Incidence and Prevalence of Pediatric Eosinophilic Esophagitis in Utah Based on a 5-Year Population-Based Study. Clin Gastroenterol Hepatol 2019; 17 (1): 107.e1–114.e1. doi: 10.1016/ j.cgh.2018.06.028.
8. Patel RV, Hirano I, Gonsalves N. Eosinophilic esophagitis: etiology and therapy. Annu Rev Med 2021; 72 : 183–197. doi: 10.1146/annurev - med-052819-023848.
9. Alkhowaiter S. Eosinophilic esophagitis. Saudi Med J 2023; 44 (7): 640–646. doi: 10.15537/smj.2023.44.7.20220812.
10. Chahuan J, Lucendo AJ. Dietary treatment for children and adults with eosinophilic esophagitis: which patient and which doctor is it suitable for? Inflamm Intest Dis 2024; 9 (1): 184–198. doi: 10.1159/000540228.
11. Amil-Dias J, Oliva S, Papadopoulou A et al. Diagnosis and management of eosinophilic esophagitis in children: an update from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr 2024; 79 (2): 394–437. doi: 10.1002/jpn3.12188.
12. Feo-Ortega S, Lucendo AJ. Evidence-based treatments for eosinophilic esophagitis: insights for the clinician. Ther Adv Gastroenterol 2022; 15 : 17562848211068665. doi: 10.1177/17562848211068665.
13. Dellon ES, Spergel JM. Biologics in eosinophilic gastrointestinal diseases. Ann Allergy Asthma Immunol 2023; 130 (1): 21–27. doi: 10.1016/j.anai.2022.06.015.
Labels
Paediatric gastroenterology Gastroenterology and hepatology SurgeryArticle was published in
Gastroenterology and Hepatology
2025 Issue 6
Most read in this issue
- Acute and chronic pancreatitis at the Centre National Hospitalier Universitaire de Cotonou from 2011 to 2022 : epidemiological, diagnostic, therapeutic, and prognostic aspects
- Swallowing disorder as the first symptom of desminopathy
- Hereditary pancreatitis as a cause of complications in the treatment of severe hematological malignancy
- Treatment strategies for pediatric gallstone disease: a systematic review