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Pediatric eosinophilic esophagitis: the Vanderbilt experience.
S Nicole Chadha1, Li Wang2, Hernan Correa3
1Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Summary
Eosinophilic esophagitis (EoE) in children shows age-related changes in allergen sensitization, with increased aeroallergen sensitivity in older children and food sensitivity in younger ones. Atopic diseases are common comorbidities in pediatric EoE patients.
Area of Science:
- Allergy and Immunology
- Pediatric Gastroenterology
- Clinical Research
Background:
- Eosinophilic esophagitis (EoE) is a chronic allergic esophageal disease.
- It involves both immediate (IgE-mediated) and delayed (non-IgE-mediated) immune responses.
- Optimal assessment of food allergen sensitization in EoE remains debated, and comorbid atopic diseases are frequent.
Purpose of the Study:
- To characterize pediatric patients diagnosed with EoE.
- To analyze aeroallergen and food sensitization profiles in relation to age.
- To investigate the association between EoE, sensitization, and comorbid atopic diseases.
Main Methods:
- Retrospective study of 211 pediatric patients with EoE.
- Analysis of aeroallergen and food sensitization using skin prick testing (SPT) and atopy patch testing (APT).
- Evaluation of comorbid atopic diseases and their relationship to sensitization patterns.
Main Results:
- Older pediatric EoE patients exhibited higher aeroallergen sensitization (pollens, dust mite).
- Younger patients showed increased food sensitization via SPT (peanut, egg, soy) and APT (potato, pork, wheat).
- Comorbid atopic diseases were common; atopic dermatitis did not correlate with increased SPT or APT food sensitization.
Conclusions:
- In pediatric EoE, aeroallergen sensitization rises with age, while food sensitization declines.
- Atopy patch testing (APT) identifies food allergens missed by skin prick testing (SPT).
- Atopic dermatitis history does not indicate non-specific SPT or APT reactivity in pediatric EoE.
