Eosinophilic oesophagitis and coeliac disease: is there an association?

Area of Science:

• Pediatric Gastroenterology
• Immunology
• Allergy

Background:

• Eosinophilic oesophagitis (EoE) is an allergic inflammatory disease of the esophagus.
• Coeliac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
• The co-occurrence of EoE and CD in children is increasingly recognized.

Purpose of the Study:

• To investigate the clinical presentation and outcomes of children with coeliac disease and eosinophilic oesophagitis.
• To evaluate the impact of dietary interventions on symptoms and esophageal histology in this patient group.

Main Methods:

• Retrospective analysis of 17 children with dyspeptic symptoms.
• Diagnosis of eosinophilic oesophagitis and coeliac disease confirmed through clinical evaluation and investigations.
• Intervention involved dietary changes: gluten-free diet for coeliac disease patients, and allergy-based restrictions for others.
• Follow-up included clinical assessment and upper gastrointestinal endoscopy.

Main Results:

• Six children (Group A) had both EoE and CD, while 11 had EoE alone (Group B).
• Group A children on a gluten-free diet showed complete symptom resolution and histological remission in some cases.
• Group B children experienced moderate symptom improvement, with significant reduction in esophageal eosinophilic infiltration in most.

Conclusions:

• This is the first reported series demonstrating an association between coeliac disease and eosinophilic oesophagitis in children.
• The findings suggest that coeliac disease may contribute to or cause esophageal eosinophilic infiltration in a subset of affected children.
• Further research is warranted to elucidate the precise relationship and underlying mechanisms.