TY - JOUR
T1 - Oesophageal eosinophilia in children with coeliac disease
AU - Ari, Anne
AU - Morgenstern, Sara
AU - Chodick, Gabriel
AU - Matar, Manar
AU - Silbermintz, Ari
AU - Assa, Amit
AU - Mozer-Glassberg, Yael
AU - Rinawi, Firas
AU - Nachmias-Friedler, Vered
AU - Shamir, Raanan
AU - Zevit, Noam
PY - 2017/9
Y1 - 2017/9
N2 - Objectives An association between coeliac disease (CD) and eosinophilic oesophagitis (EoE)/oesophageal eosinophilia (EE) has been suggested. We sought to characterise children with CD+EE in-depth and assess the contribution of each condition to the clinical presentation and treatment response. Study design Medical records of children with both CD+EE, or isolated EoE diagnosed between 2000 and 2014, were retrospectively reviewed and compared with patients with isolated CD or epigastric pain. Frequency of EE was calculated from endoscopy results of patients with suspected CD or epigastric pain between 2011 and 2014. Missing data were obtained via a telephone questionnaire. Setting Single large, tertiary paediatric centre. Patients 17 CD+EE, 46 EoE, 302 isolated CD and 247 epigastric pain. Results The patients with CD+EE shared characteristics of both individual conditions. While age at diagnosis, family history of autoimmunity/CD and anaemia were similar to patients with CD, other characteristics such as male gender, personal/family history of atopy, peripheral eosinophilia and oesophageal white papules were more similar to patients with EoE. Combined patients (CD+EE) tended to present with CD-associated symptoms; the majority (63%) later developed typical EoE symptoms. Only a minority (21%) of combined patients had EE that resolved after a gluten-free diet; another 21% had normalisation of EE upon proton pump inhibitor treatment. The remainder required EoE-specific treatment. Conclusion Patients with CD found to have EE share characteristics with both isolated CD and EoE. It appears that these are two coexisting entities presenting in the same patient rather than eosinophilia associated with CD, and therefore, interventions separately addressing each condition may be considered.
AB - Objectives An association between coeliac disease (CD) and eosinophilic oesophagitis (EoE)/oesophageal eosinophilia (EE) has been suggested. We sought to characterise children with CD+EE in-depth and assess the contribution of each condition to the clinical presentation and treatment response. Study design Medical records of children with both CD+EE, or isolated EoE diagnosed between 2000 and 2014, were retrospectively reviewed and compared with patients with isolated CD or epigastric pain. Frequency of EE was calculated from endoscopy results of patients with suspected CD or epigastric pain between 2011 and 2014. Missing data were obtained via a telephone questionnaire. Setting Single large, tertiary paediatric centre. Patients 17 CD+EE, 46 EoE, 302 isolated CD and 247 epigastric pain. Results The patients with CD+EE shared characteristics of both individual conditions. While age at diagnosis, family history of autoimmunity/CD and anaemia were similar to patients with CD, other characteristics such as male gender, personal/family history of atopy, peripheral eosinophilia and oesophageal white papules were more similar to patients with EoE. Combined patients (CD+EE) tended to present with CD-associated symptoms; the majority (63%) later developed typical EoE symptoms. Only a minority (21%) of combined patients had EE that resolved after a gluten-free diet; another 21% had normalisation of EE upon proton pump inhibitor treatment. The remainder required EoE-specific treatment. Conclusion Patients with CD found to have EE share characteristics with both isolated CD and EoE. It appears that these are two coexisting entities presenting in the same patient rather than eosinophilia associated with CD, and therefore, interventions separately addressing each condition may be considered.
KW - Coeliac disease
KW - Eosinophilic oesophagitis
KW - celiac disease
KW - eosinophilic esophagitis
KW - esophageal eosinophilia
UR - http://www.scopus.com/inward/record.url?scp=85029667630&partnerID=8YFLogxK
U2 - 10.1136/archdischild-2016-311944
DO - 10.1136/archdischild-2016-311944
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C2 - 28404554
AN - SCOPUS:85029667630
SN - 0003-9888
VL - 102
SP - 825
EP - 829
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
IS - 9
ER -