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儿童食管嗜酸性粒细胞增多症:一项为期6年的单中心经验。

Esophageal eosinophilia in children: A 6-year single-center experience.

作者信息

Çakır Murat, Sağ Elif, Mungan Sevdegül, Akbulut Ulaş Emre, Orhan Fazıl

机构信息

Departments of Pediatric Gastroenterology Hepatology and Nutrition, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.

Departments of Pathology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.

出版信息

Turk J Pediatr. 2017;59(4):369-378. doi: 10.24953/turkjped.2017.04.002.

Abstract

Çakır M, Sağ E, Mungan S, Akbulut UE, Orhan F. Esophageal eosinophilia in children: A 6-year single-center experience. Turk J Pediatr 2017; 59: 369-378. Esophageal eosinophilia (EE) and eosinophilic esophagitis (EoE) are emerging clinical entities, the prevalence of which has increased during the last 15 years. However, there is a lack of data concerning the etiology and outcomes of EE in children. The aim of this study was therefore to analyze the clinical findings and outcomes of children with EE and EoE in our pediatric gastroenterology unit over a 6-year period. The study included children undergoing esophagogastroduodenoscopy (EGD) during this 6-year period (January 2010 to December 2015) in our pediatric gastroenterology unit. The files of patients with EE were re-evaluated in detail to elicit demographic features, clinical, laboratory and histopathological findings, treatment modalities and outcomes. EE was determined in 33 patients [0.95% (95% CI: 0.63-1.27) among all children, and in 4.66% (95% CI: 3.11-6.21) of children undergoing esophageal biopsy] (8.6±4.2 years and 72.7% male). EoE was the most common cause of EE (n=11, 33.3%), followed by eosinophilic gastroenteropathy (n=6, 18.1%) and proton pump inhibitor responsive esophageal eosinophilia (n=4, 12.1%). Patients with EoE (n=11) were followed up for 21.2±18 (range: 1-60) months, and treatment was discontinued in 2 patients (18.1%). Additionally, 5 patients (45.5%) received diet elimination only and 1 patient (9%) received a combination of low dose steroids and diet. Three patients (27.2%) are still being treated under the initial regimen. The overall incidence of EE increased in 2014-2015 compared to 2010-2011 (0.41% vs. 1.33, p=0.047, OR: 3.22 and 95% CI: 0.94-10.98, p=0.06). EE is an increasingly common clinical entity with a wide spectrum of etiology and clinical presentations in children.

摘要

恰基尔M、萨厄E、蒙甘S、阿克布卢特UE、奥尔汉F。儿童食管嗜酸性粒细胞增多症:一项为期6年的单中心经验。《土耳其儿科学杂志》2017年;59:369 - 378。食管嗜酸性粒细胞增多症(EE)和嗜酸性粒细胞性食管炎(EoE)是新出现的临床病症,在过去15年中其患病率有所上升。然而,关于儿童EE的病因和结局的数据匮乏。因此,本研究的目的是分析我们儿科胃肠病科6年间EE和EoE患儿的临床发现和结局。该研究纳入了我们儿科胃肠病科在这6年期间(2010年1月至2015年12月)接受食管胃十二指肠镜检查(EGD)的儿童。对EE患儿的病历进行了详细重新评估,以获取人口统计学特征、临床、实验室和组织病理学发现、治疗方式及结局。在33例患者中确定了EE[在所有儿童中占0.95%(95%置信区间:0.63 - 1.27),在接受食管活检的儿童中占4.66%(95%置信区间:3.11 - 6.21)](年龄8.6±4.2岁,男性占72.7%)。EoE是EE最常见的病因(n = 11,33.3%),其次是嗜酸性粒细胞性胃肠病(n = 6,18.1%)和质子泵抑制剂反应性食管嗜酸性粒细胞增多症(n = 4,12.1%)。EoE患者(n = 11)随访了21.2±18(范围:1 - 60)个月,2例患者(18.1%)治疗中断。此外,5例患者(45.5%)仅接受饮食排除治疗,1例患者(9%)接受低剂量类固醇和饮食联合治疗。3例患者(27.2%)仍在初始治疗方案下接受治疗。与2010 - 2011年相比,2014 - 2015年EE的总体发病率有所上升(0.41%对1.33,p = 0.047,比值比:3.22,95%置信区间:0.94 - 10.98,p = 0.06)。EE是一种在儿童中病因和临床表现范围广泛且日益常见的临床病症。

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