Eosinophilic Esophagitis among Children at King Hussein Medical Center

Abstract

Objective: Eosinophilic esophagitis is a clincopathologic entity characterized by esophageal symptoms in association with a dense eosinophilic infiltrate, the aim of this study is to describe the clinical presentation, laboratory, endoscopic and histopathologic results in children diagnosed with eosinophilic esophagitis. Methods: This is a retrospective review of the medical records for 38 children with histologic diagnosis of eosinophilic esophagitis performed at King Hussein Medical Center, during the period between January 2001 to February 2011, with the cut off biopsy diagnosis ≥20/HPF eosinophilic infiltrate. Patients were excluded if gastric or duodenal biopsies showed prominent eosinophilic infiltrate. Patients medical records were reviewed regarding age at presentation, gender, clinical presentation, associated disease. Laboratory, endoscopic and histologic results were also reviewed. Results: A total 38 patients with histological diagnosis of eosinophilic esophagitis were included in this study. Thirty-one (82%) were males and 7 (18%) were females. Their ages ranged between 2-14 years. Mean age 8 years. The most commonly clinical presentation of eosinophilic esophagitis was vomiting which occurred among 26 children (68%), however, rash was presented in only one child (2%). Peripheral eosinophilia >(0.5×10/L) was found in 45%. High serum IgE level (>100 IU/ml) was found in 39%. Positive radio allergo sorbent testing in 39%. The most frequent endoscopic findings were loss of normal vascularity found in 19 (50%) children, however, white exudates were found in 2(5%) children. Mean eosinophil count was 70 (20-120), eosinophilic degranulation, and bazal zone hyperplasia reported in 18 children (47%). Conclusion: Eosinophilic esophagitis in Jordan displays similar clinical, endoscopic and pathologic features to those described in other countries. Endoscopic and histologic feature remain the gold standard for diagnosis of eosinophilic esophagitis

Clinico-pathological characteristics of eosinophilic esophagitis in Jordanian children

“…The majority of the patients were boys. The authors concluded that EoE in Jordan had clinical, endoscopic, and pathological features similar to those described in other countries [12].…”

“…Although our study was not a true epidemiological study and there are no previous numbers for comparison, when comparing our numbers (21 cases in 5 years) to the number of diagnosed cases in another referral centre in Jordan with a higher endoscopy service volume [12] (38 cases over 10 years), the incidence may be increasing. EoE is reported more frequently in men than in women.…”

“…It has been commonly reported in the pediatric population; however, it has recently been increasingly recognized in the adult population [12,14]. Although there has been an increase in the incidence of EoE cases in both pediatric and adult populations, there have been few studies conducted in Jordan [12,15,16]. In our study, we aimed to provide more data about EoE in Jordanian children, its relative frequency, and its clinicopathological characteristics.…”

“…EoE is a chronic immune-mediated disorder characterized by clinicopathological findings related to esophageal dysfunction clinically and eosinophil-predominant inflammation histologically [13]. It has been commonly reported in the pediatric population; however, it has recently been increasingly recognized in the adult population [12,14]. Although there has been an increase in the incidence of EoE cases in both pediatric and adult populations, there have been few studies conducted in Jordan [12,15,16].…”

“…A previous study from central Saudi Arabia estimated the relative frequency of EoE in children who underwent upper endoscopy for any reason at 4.8% [19]. A newer report from the same group 5 years later reported a 2-fold rate of approximately 9.3% [12].…”