Eosinophilic oesophagitis in children: an uncommon occurrence in a predominantly Chinese population in Singapore

Tan, Li Nien Michelle; Srivastava, Supriya; Teh, Ming; Quak, Seng Hock; Aw, Marion

doi:10.11622/smedj.2016060

Cited by 6 publications

(12 citation statements)

References 25 publications

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“…The various reported incidences of EoE in children are an effect of the different methodology used in studies and the availability for endoscopic procedure necessary for diagnosis [5]. Male dominance among patients with EoE has been already reported and a similar result was noted in our study [11,12]. It has been hypothesized that single nucleotide polymorphisms (SNP) in the thymic stromal lymphopoietin (TSLP) gene and nonsynonymous SNP in the TSLP receptor may be associated with EoE only in male patients [13].…”

Section: Discussionsupporting

confidence: 83%

“…Abnormalities in endoscopic examination may be divided into inflammatory features (edema, exudate, furrowing) often observed in children and fibro-stenotic features (rings, stricture) more common for adults [31,32]. Regardless of which region of the world, similar endoscopic changes are reported among children with EoE [8,10,12,14,15,31]. However, it should be known that a visually normal esophagus does not exclude the diagnosis of EoE.…”

Section: Discussionmentioning

confidence: 99%

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Eosinophilic Esophagitis in Children in North-Eastern Poland

Zdanowicz

Kucharska

Sobaniec-Łotowska

et al. 2020

JCM

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Background: An increase in the incidence of eosinophilic esophagitis worldwide is being observed in children. The aim of the study was to analyze the incidence, clinical manifestations, biochemical markers and endoscopic features of children with eosinophilic esophagitis in comparison to patients with non-eosinophilic esophagitis. Methods: This single-center retrospective study included newly diagnosed children with eosinophilic (EoE) and non-eosinophilic (non-EoE) esophagitis based on endoscopic and histopathological results between January 2013 and December 2018. Result: Among 433 of enrolled children with esophagitis, 36 (8.31%) were diagnosed with EoE (median age of 10 years). Male predominance and an increased percentage of allergy cases in the EoE group were noticed. Dysphagia was the only symptom that significantly differentiated both groups (p = 0.006). Endoscopic findings with relevant relationships with EoE included linear fissuring, decreased vascular pattern, trachealization and whitish exudates. No significant difference in the prevalence of other reported diseases between groups was observed. Conclusion: The results of EoE analysis in children from North-Eastern Poland did not differ from reports from other countries. The reported symptoms were not specific for EoE, and only dysphagia and some endoscopic lesions were helpful to differentiate children with EoE from non-EoE.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Eosinophilic Esophagitis in Children in North-Eastern Poland

Zdanowicz

Kucharska

Sobaniec-Łotowska

et al. 2020

JCM

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“…EoE is an antigen‐driven, eosinophil‐predominant disorder with Th2 cytokine profile and has been frequently associated with asthma, atopic dermatitis, food allergies, and aeroallergens 32 . History of atopic diseases is reported in 30–50% of children with EoE, with bronchial asthma being the commonest, as was seen in our cohort 19–22 . The presence of peripheral eosinophilia was reported in 8.6–33% of patients, similar to our findings 18,20 …”

Section: Discussionsupporting

confidence: 89%

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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“…The diagnosis of EoE is dependent on the coupling characteristics of endoscopic and histopathological findings. The universal macroscopic findings are linear furrows, whitish papules, and stricturing, whereas microscopically, in addition to the esophageal eosinophilia, basal cell hyperplasia and eosinophilic abscesses can be found [28,[30][31][32]. The most common endoscopic finding was linear furrows, followed by esophageal rings and whitish spots.…”

Section: Discussionmentioning

confidence: 99%

Clinico-pathological characteristics of eosinophilic esophagitis in Jordanian children

Altamimi¹,

Ahmad²,

Abu-Aqoulah³

et al. 2022

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Introduction: Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disorder manifested by symptoms of impaired esophageal function and hypereosinophilic esophageal inflammation. It is believed that the number of patients being diagnosed globally is increasing.Aim: To describe the frequency and clinicopathological features of EoE in Jordanian children.Material and methods: A retrospective review of all paediatric patients with eosinophilic esophagitis diagnosed and followed up at our paediatric gastroenterology service at King Abdullah University Hospital between January 2015 and January 2020.Results: During the study period, 21 patients were diagnosed with EoE out of 700 diagnostic endoscopic procedures. Only 1 (4.8%) female was diagnosed. The average age at presentation was 9.5 years (age range: 1-16 years). The most common manifestation was solid food dysphagia (15, 71.4%), followed by food impaction and vomiting (11, 52.4% and 6, 28.6%, respectively). Atopy was diagnosed in 10 (47.6%) patients. Four (19.0%) had food allergy, 3 (14.3%) had respiratory allergy, and 3 (14.3%) had combined. Linear furrows and circular rings were the most common endoscopic features -17 (81.0%) and 10 (47.6%), respectively, while papillary elongation, basal zone hyperplasia, and eosinophilic infiltrate were the most common reported histopathological features. Almost all patients received proton pump inhibitors (19, 90.5%). Steroids were used in 18 (85.7%) patients; local steroids in 11 (52.4%), and oral steroids in 7 (33.3%). Out of the 4 (19%) patients with esophageal strictures, 2 (9.5%) required pneumatic dilatation.Conclusions: Eosinophilic esophagitis is not uncommon in our community. Clinical and histological parameters point to delayed referral and diagnosis. Increasing awareness of this problem will lead to early diagnosis and will decrease complications.

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Eosinophilic oesophagitis in children: an uncommon occurrence in a predominantly Chinese population in Singapore

Cited by 6 publications

References 25 publications

Eosinophilic Esophagitis in Children in North-Eastern Poland

Eosinophilic Esophagitis in Children in North-Eastern Poland

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

Clinico-pathological characteristics of eosinophilic esophagitis in Jordanian children

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