Eosinophilic esophagitis in children with esophageal atresia

Dhaliwal, Jasbir; Tobias, Vivienne; Sugo, Ella; Varjavandi, Vincent; Lemberg, Daniel A.; Day, Andrew S.; Bohane, T. D.; Ledder, Oren; Jiwane, Ashish; Adams, Susan; Henry, Guy; Dilley, A.; Shi, Enyi; Krishnan, Usha

doi:10.1111/dote.12119

Cited by 64 publications

(129 citation statements)

References 34 publications

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“…In relation to the clinical presentation, this study found a significantly higher incidence of GERD symptoms, such as vomiting and dysphagia, among patients with EoE compared to those without EoE. 6,18,22 As it is known in EoE, in all series, associated atopy was frequent (Dhaliwal: 50%; Batres: 66%; Gorter: 50%). 3,18,23 A normal endoscopy, linear furrows, edema, and white exudates were described as endoscopic findings.…”

Section: Esophageal Atresia and Eosinophilic Esophagitismentioning

confidence: 59%

“…6,18,22 As it is known in EoE, in all series, associated atopy was frequent (Dhaliwal: 50%; Batres: 66%; Gorter: 50%). 3,18,23 A normal endoscopy, linear furrows, edema, and white exudates were described as endoscopic findings. 18,21,22 Multiple biopsies of both the proximal and distal parts of the anastomosis are recommended for EoE diagnosis.…”

Section: Esophageal Atresia and Eosinophilic Esophagitismentioning

confidence: 78%

“…It is secondary to esophageal dysmotility, short esophagus, lower esophageal sphincter pressure, and chronic lung disease. 4,17,18 Dysmotility is the result of intrinsic factors related to abnormal esophagus development or partial denervation during surgery. Motor patterns were described in a cohort of children with EA using a high resolution manometry.…”

Section: Esophageal Atresiamentioning

confidence: 99%

“…The largest series was published by Dhaliwal et al, which established a 17% incidence (18 cases). 18 Several hypothesis explain the highest frequency of EoE and EA: 1) alterations in esophageal motility lead to a prolonged exposure to potential allergens, thus increasing the risk of local sensitization; 2) GERD causes mucosal injury and may impair the mucosal barrier function and predispose to EoE; 3) food impaction secondary to dysmotility and esophageal stricture associated with EA may damage the mucosa and cause eosinophilic infiltration; 4) long-term exposure to acid suppression, which is common among children with EA, may increase food protein allergenicity; 5) the 16q24 microdeletion involving the FOX transcription factor gene, in humans, has been associated with EA, cardiac, anorectal, renal, gastrointestinal, and vertebral anomalies. Curiously, FOXF1 genes have been identified in mice, and FOXF1 binding sites are present not only in the promoter region of genes that are critical for mesenchymal proliferation but also in the inflammation promoter region, including those for eotaxin and interleukin.…”

Section: Esophageal Atresia and Eosinophilic Esophagitismentioning

confidence: 99%

“…3,18,23 A normal endoscopy, linear furrows, edema, and white exudates were described as endoscopic findings. 18,21,22 Multiple biopsies of both the proximal and distal parts of the anastomosis are recommended for EoE diagnosis. 19 In EA, anastomotic stricture occurs in 5-15% of patients, mainly in the first year of life.…”

Section: Esophageal Atresia and Eosinophilic Esophagitismentioning

confidence: 99%

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Eosinophilic esophagitis and esophageal atresia: coincidence or causality?

Salgado

Rocca

2018

Arch Argent Pediatr

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Eosinophilic esophagitis is an immune-mediated chronic disease of the esophagus characterized by symptoms related to esophageal dysfunction and tissue eosinophilia. In the endoscopy, the esophageal mucosa may appear normal or show exudates, rings, edema, furrows, and strictures. Its management is based on elimination diet, topical corticosteroids and/or esophageal dilation. Atresia is the most common congenital alteration of the esophagus; it requires surgical repair and poses potential complications, such as gastroesophageal reflux, strictures, and esophageal dysmotility. Up to 2015, 48 cases of eosinophilic esophagitis and esophageal atresia were reported, with dysmotility, reflux, and long-term acid suppression involvement. Prevalent clinical signs include dysphagia, difficulty eating, and reflux symptoms, so an esophagogastroduodenoscopy with biopsy is recommended to rule out associated eosinophilic esophagitis in patients with esophageal atresia and persistent symptoms before performing an esophageal dilation and/or anti-reflux surgery. If eosinophilic esophagitis is confirmed, it should be managed with the corresponding drugs, and the subsequent therapeutic approach will depend on its clinical course.

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Section: Esophageal Atresia and Eosinophilic Esophagitismentioning

confidence: 59%

Section: Esophageal Atresia and Eosinophilic Esophagitismentioning

confidence: 78%

Section: Esophageal Atresiamentioning

confidence: 99%

Section: Esophageal Atresia and Eosinophilic Esophagitismentioning

confidence: 99%

Section: Esophageal Atresia and Eosinophilic Esophagitismentioning

confidence: 99%

See 3 more Smart Citations

Eosinophilic esophagitis and esophageal atresia: coincidence or causality?

Salgado

Rocca

2018

Arch Argent Pediatr

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Eosinophilic esophagitis in children: A cross‐sectional study from a tertiary care center

Samanta,

Poddar,

Kumari

et al. 2023

JGH Open

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Background and AimThe prevalence of eosinophilic esophagitis (EoE) is rising in the West. However, data from the Indian subcontinent is limited. In this prospective cross‐sectional study, we estimated the prevalence of EoE among children undergoing elective upper gastrointestinal endoscopy (UGIE).MethodsWe enrolled 200 consecutive children (123 boys, median age 10.25 years [interquartile range 8.25–14.5]) between March 2020 and November 2022 at our center. Clinical characteristics, endoscopic findings, and laboratory parameters were noted. A total of 12 mucosal biopsies (3 each from the middle and lower third of the esophagus, stomach, and duodenum) were obtained. EoE was diagnosed if the peak eosinophil count was ≥15/high‐power field (HPF) in absence of gastric and duodenal eosinophilia.ResultsThe commonest indications for UGIE were gastroesophageal reflux disease‐like symptoms (29%), inflammatory bowel disease (22.5%), celiac disease (15%), and abdominal pain (13%). EoE was detected in seven children, suggesting an overall prevalence of 3.5%. Of the 20 children evaluated for dysphagia, 4 (20%) had EoE. Also, two of three (67%) children presented with food bolus impaction along with dysphagia had EoE. Of the seven children with EoE, three (43%) had bronchial asthma, two (28.5%) had peripheral eosinophilia, and one (14%) had elevated serum IgE. Trachealization and linear furrows were found in 57% and 71% cases, respectively. Four children received high‐dose proton pump inhibitor (PPI) for 12 weeks, two received PPI+ stricture dilatation, and one received systemic steroids. All achieved clinical, endoscopic, and histopathological remission.ConclusionHospital‐based prevalence of EoE among children undergoing elective UGIE was 3.5%. EoE patients had favorable outcomes with PPI.

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Proton pump inhibitors in esophageal atresia: A systematic review and meta‐analysis

Dimitrov,

Aumar,

Duhamel

et al. 2024

J. pediatr. gastroenterol. nutr.

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Gastroesophageal reflux disease (GERD) is frequent and prolonged in esophageal atresia (EA) pediatric patients requiring routine use of proton pump inhibitors (PPIs). However, there are still controversies on the prophylactic use of PPIs and the efficacy of PPIs on GERD and EA complications in this special condition. The aim of the study is to assess the prophylactic use of PPIs in pediatric patients with EA and its complications. We, therefore, performed a systematic review including all reports on the subject from 1980 to 2022. We conducted meta‐analysis of the pooled proportion of PPI—and no PPI groups using random effect model, meta‐regression, and estimate heterogeneity by heterogeneity index I2. Thirty‐eight reports on the topic met the criteria selection, representing a cumulative 6044 patients with EA. Prophylactic PPI prescription during the first year of life does not appear to prevent GERD persistence at follow‐up and is not associated with a significantly reduced rate of antireflux surgical procedures (ARP). PPIs improve peptic esophagitis and induce remission of eosinophilic esophagitis at a rate of 50%. Their effect on other GERD outcomes is uncertain. Evidence suggests that PPIs do not prevent anastomotic stricture, Barrett's esophagus, or respiratory complications. PPI use in EA can improve peptic and eosinophilic esophagitis but is ineffective on the other EA complications. Side effects of PPIs in EA are almost unknown.

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Eosinophilic esophagitis in children with esophageal atresia

Cited by 64 publications

References 34 publications

Eosinophilic esophagitis and esophageal atresia: coincidence or causality?

Eosinophilic esophagitis and esophageal atresia: coincidence or causality?

Eosinophilic esophagitis in children: A cross‐sectional study from a tertiary care center

Proton pump inhibitors in esophageal atresia: A systematic review and meta‐analysis

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