Eosinophilic esophagitis: Does age matter?

Area of Science:

• Pediatric Gastroenterology
• Immunology
• Allergy

Background:

• Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal disease.
• Diagnosis is common in school-aged children (6-9 years), but data on younger children is limited.

Purpose of the Study:

• To compare clinical presentation, comorbidities, and treatment outcomes of EoE based on age at diagnosis in children.
• To identify age-specific patterns in EoE presentation and response to therapy.

Main Methods:

• Retrospective chart review of 256 children (<18 years) diagnosed with EoE between 2005-2020.
• Patients were categorized into three age groups: <2 years, 2-<6 years, and 6-<18 years.
• Clinical data, family history, comorbidities, treatment, and endoscopic findings were analyzed.

Main Results:

• Vomiting was common in children <2 years; poor weight gain was more prevalent in the 2-<6 years group.
• Older children (6-18 years) were more likely to present with food impaction and abdominal pain.
• Combination therapy achieved higher remission rates (85%) in children <6 years compared to older children (66%).

Conclusions:

• EoE should be suspected in young children with feeding difficulties and poor weight gain.
• Combination therapy may be more effective for younger children with EoE.
• Further research with larger cohorts is needed to optimize combination therapy strategies for pediatric EoE.