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Inicio Allergologia et Immunopathologia Children with eosinophilic esophagitis in real life: 10 years’ experience with...
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Vol. 48. Issue 3.
Pages 244-250 (May - June 2020)
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Vol. 48. Issue 3.
Pages 244-250 (May - June 2020)
DOI: 10.1016/j.aller.2019.07.013
Children with eosinophilic esophagitis in real life: 10 years’ experience with a focus on allergic management
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Pauline Azzanoa,
Corresponding author
pauline.azzano@chu-lyon.fr

Corresponding author.
, Florence Villard Truca, Sophie Collardeau-Frachonb,c, Alain Lachauxa,c
a Service d’Hépatologie, Gastroentérologie et Nutrition pédiatriques, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, France
b Service d’Anatomopathologie, Groupement hospitalier Est, Hospices Civils de Lyon, Bron, France
c Université Claude Bernard Lyon 1, Lyon, France
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Tables (2)
Table 1. Endoscopic features in our cohort of patients with EoE. Endoscopic features in initial endoscopy in our cohort. We found similar reports than in the literature, with the presence of white spots in 92.5% of our patients, furrows in 28.7% and strictures in 14.9%. Nodules and trachealization were less frequent.
Table 2. Repartition of allergy testing. Table 2 describes allergy testing in our cohort, with percentage of patients who benefited from food prick tests, environmental prick tests, skin patch tests, and specific IgE levels. Thus, a majority of our cohort benefited from allergy testing, which was frequently positive.
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Abstract
Introduction and objectives

Eosinophilic esophagitis (EoE) is frequently miss-diagnosed or overlooked for several years because of the invasiveness of investigations and the non-specificity of symptoms in childhood. Due to the lack of specific recommendations in children, its management remains very heterogeneous, especially concerning allergy testing. The aim of this study is to analyze our population and practices, in comparison with the literature, with a focus on allergic management, to harmonize and optimize our practice.

Material and methods

We included all children with a diagnosis of EoE at the Hospital Femme Mere Enfant, Bron, France. Data were collected via retrospective chart review.

Results

108 patients were included with an average age of 9.5 years. Average delay before diagnosis was 6.65 years. Symptoms varied with age, with a predominance of vomiting (60% of patients), feeding difficulties (72%) and growth difficulties (24%) in children <5 years, whereas older children often presented with feeding blockage (64%) and dysphagia (61%). Cough was frequent in our cohort (18.5%), especially in children <10 years (38.5% between three and five years). The allergic background was frequent (70.3%) and 80% of our patients benefited from allergy testing. Allergy testing was particularly useful to guide therapy as elimination diet represented an effective treatment in 60% of our patients

Conclusions

Allergy testing has to be harmonized to include major allergens (egg, milk, peanut, fish, wheat, and soy), including prick and patch tests. Allergy-testing based diet seemed to be the best compromise between efficiency and constraints, especially in mono-sensitized patients.

Keywords:
Eosinophilic esophagitis
Pediatric
Allergy testing
Real life
Analysis of practices

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