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An Immunofluorescent Method for Characterization of Barrett’s Esophagus Cells
Published on: July 20, 2014
Barrett's esophagus in children and adolescents without neurodevelopmental or tracheoesophageal abnormalities: a
Dang M Nguyen1, Hashem B El-Serag, Mitchell Shub
1Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030, USA.
Insights
Barrett's esophagus (BE) is rare in children without developmental issues, with a prevalence of 0.12% for intestinal metaplasia. This study evaluated BE in pediatric patients undergoing endoscopy, finding few confirmed cases.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Endoscopy
- Esophageal Diseases
Background:
- Barrett's esophagus (BE) in children is primarily documented through retrospective case series and cross-sectional studies.
- Limited prospective data exists on BE prevalence and associated factors in pediatric populations without specific comorbidities.
Purpose of the Study:
- To determine the prevalence of BE in children without neurodevelopmental disorders or tracheoesophageal abnormalities.
- To identify potential determinants associated with BE in this specific pediatric cohort.
Main Methods:
- A prospective, cross-sectional study was conducted across three pediatric gastroenterology centers.
- 840 children and adolescents undergoing elective upper endoscopy, excluding those with neurodevelopmental or tracheoesophageal disorders, were enrolled.
- Endoscopic assessments and esophageal biopsies were performed to confirm or exclude BE.
Main Results:
- The prevalence of endoscopically suspected BE was 1.43%, with only 0.12% confirmed histologically (intestinal metaplasia).
- Patients with suspected BE exhibited higher mean body mass index and reported more chest pain compared to controls.
- A trend towards increased dysphagia, heartburn, and regurgitation was observed in patients with suspected BE.
Conclusions:
- Barrett's esophagus is uncommon in children without neurodevelopmental delay or tracheoesophageal anomalies undergoing elective upper endoscopy.
- The study's findings on BE prevalence in children are limited by the small number of confirmed cases.
Background:
Barrett's esophagus (BE) in children has been examined in retrospective studies, consisting of case series and cross-sectional studies.
Objective:
To evaluate the prevalence and determinants of BE in children who are free from neurodevelopmental disorders and tracheoesophageal abnormalities.
Design:
A prospective, cross-sectional study.
Setting:
Three pediatric GI Centers in Houston, Texas; Phoenix, Arizona; and Portland, Maine between February 2006 and December 2007.
Patients:
This study involved children and adolescents consecutively presenting for elective upper endoscopy. Patients with neurodevelopmental and tracheoesophageal disorders were excluded.
Intervention:
Endoscopic pictures of all cases with suspected BE were independently reviewed and verified by two experienced investigators. Esophageal biopsy specimens were obtained in all patients, and targeted biopsy specimens also were obtained from suspected BE.
Main Outcome Measurements:
Endoscopically suspected BE and histologically confirmed BE.
Results:
A total of 840 patients (mean age 9.5 years) were enrolled and had complete questionnaire and endoscopic data. Twelve patients were suspected of having BE (prevalence of 1.43%; 95% confidence interval [CI], 0.73-2.45), and only 1 patient had intestinal metaplasia, for a prevalence of 0.12% (95% CI, 0-0.65), whereas the rest had gastric oxyntic glands (n=6) or squamous esophageal epithelium (n=5). Patients with suspected BE had a higher mean body mass index (23.0 vs 19.1, P=.05) and more chest pain (50% vs 13%, P<.01) than patients without BE or reflux esophagitis. There was a trend toward a higher frequency of dysphagia, heartburn, and regurgitation in patients with suspected BE.
Limitations:
The accuracy of BE prevalence estimates is limited by the small number of cases.
Conclusion:
BE is rare in children without neurodevelopmental delay or tracheoesophageal anomalies presenting for elective upper endoscopy.
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