Eosinophilic esophagitis in children: A multicenter study evaluating current practices in Mexico

Area of Science:

• Pediatric Gastroenterology
• Immunology
• Allergy

Background:

• Eosinophilic esophagitis (EoE) is a chronic immune disorder affecting the esophagus, leading to varied symptoms and diagnostic challenges in children.
• Current diagnostic and treatment practices for pediatric EoE show significant variability.

Purpose of the Study:

• To evaluate diagnostic and treatment strategies for pediatric EoE in Mexico.
• To identify common clinical presentations of EoE in children.
• To investigate the role of IgG4 in pediatric EoE.

Main Methods:

• Retrospective analysis of 32 pediatric patients diagnosed with EoE.
• Data collection included clinical symptoms, endoscopic and histologic findings, and allergy assessments.
• Evaluation of IgG4-positive plasma cells in esophageal biopsies.

Main Results:

• Median age of patients was 10.6 years, with a median diagnostic delay of 15.5 months.
• Food impaction was the most frequent symptom; 82% had a history of atopy.
• EoE confirmed histologically in 83.8% of biopsies; IgG4-positive plasma cells found in 76.5% of patients.
• Dupilumab treatment led to significant clinical improvement.

Conclusions:

• Challenges persist in diagnosing and managing pediatric EoE, necessitating standardized approaches.
• The presence of IgG4 suggests a potential role in EoE pathophysiology.
• Further research is required to establish treatment guidelines and confirm dupilumab's efficacy.