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嗜酸性食管炎:西班牙中部某地区儿童和青少年的人口统计学、临床、内镜、组织学及特应性特征

Eosinophilic Esophagitis: Demographic, Clinical, Endoscopic, Histologic, and Atopic Characteristics of Children and Teenagers in a Region in Central Spain.

作者信息

Gómez Torrijos E, Sánchez Miranda P, Donado Palencia P, Castro Jimenez A, Rodriguez Sánchez J, Mendez Díaz Y, Moreno Lozano L, García Rodríguez R

机构信息

Allergy Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.

Pediatric Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.

出版信息

J Investig Allergol Clin Immunol. 2017;27(2):104-110. doi: 10.18176/jiaci.0112. Epub 2016 Oct 10.

Abstract

BACKGROUND AND OBJECTIVE

Eosinophilic esophagitis (EoE) is an increasingly prevalent chronic inflammatory disease of the esophagus with an immunoallergic etiology. Few studies have been published on EoE in children and adolescents. The objective of this study was to analyze the demographic, clinical, serologic, endoscopic-histologic, and atopic characteristics of pediatric patients with EoE and to identify atopic and digestive comorbidities.

METHODS

We conducted a prospective observational study in children and adolescents (<16 years) assessed in a specialized multidisciplinary EoE unit in a tertiary referral hospital in a central region of Spain between 2011 and 2015.

RESULTS

Thirty-five patients were included in the study. Twenty-eight (80%) were male. The mean age was 9.6 years, 83% were atopic, and 28% reported a family history of atopy. The most common symptom was dysphagia (51%). Eosinophilia was detected in the blood of 60% of patients. Eosinophil cationic protein and total IgE were elevated in 88% and 77% of patients, respectively. The most frequent endoscopic finding was linear grooves (57%). Skin tests with aeroallergens were positive in 82% of patients (pollen 62% and food 60%). The main atopic comorbidities were asthma (48%) and rhinoconjunctivitis (37%). Digestive diseases were more often associated with gastritis and Helicobacter pylori infection (17%).

CONCLUSIONS

Our results are similar to those previously reported. EoE is more common in boys and in individuals with a history of atopy and sensitization to airborne allergens and food. These results support the consideration of EoE as an atopic disease and underline the important role of allergists in early diagnosis and treatment.

摘要

背景与目的

嗜酸性粒细胞性食管炎(EoE)是一种病因与免疫过敏相关、日益常见的食管慢性炎症性疾病。关于儿童和青少年EoE的研究报道较少。本研究的目的是分析儿童EoE患者的人口统计学、临床、血清学、内镜组织学及特应性特征,并确定特应性和消化系统合并症。

方法

我们对2011年至2015年间在西班牙中部地区一家三级转诊医院的专业多学科EoE诊疗单元接受评估的儿童和青少年(<16岁)进行了一项前瞻性观察研究。

结果

35例患者纳入研究。28例(80%)为男性。平均年龄9.6岁,83%有特应性,28%有特应性家族史。最常见症状为吞咽困难(51%)。60%的患者血液中检测到嗜酸性粒细胞增多。88%和77%的患者嗜酸性粒细胞阳离子蛋白和总IgE升高。最常见的内镜表现为线性沟(57%)。82%的患者气传变应原皮肤试验呈阳性(花粉62%,食物60%)。主要的特应性合并症为哮喘(48%)和鼻结膜炎(37%)。消化系统疾病更多与胃炎和幽门螺杆菌感染相关(17%)。

结论

我们的结果与先前报道的相似。EoE在男孩以及有特应性病史且对空气传播变应原和食物致敏的个体中更常见。这些结果支持将EoE视为一种特应性疾病,并强调了过敏症专科医生在早期诊断和治疗中的重要作用。

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