Institut de Pathologie, CHU Lille.
Centre de Référence des Affections Chroniques et Malformatives de l'Œsophage, CHU Lille, Lille Inflammation Research International Center, University Lille, Lille.
J Pediatr Gastroenterol Nutr. 2019 Jul;69(1):52-56. doi: 10.1097/MPG.0000000000002261.
Eosinophilic esophagitis (EoE) is an increasingly recognized childhood disease. Esophageal atresia (EA) is the most frequent congenital malformation of the esophagus. Recently, cases of EoE occurring in patients with EA have been reported, although the exact prevalence of EoE in EA remains unknown. The aim is to investigate the prevalence of EoE among EA in adolescents and to describe these patients' characteristics.
Systematic upper gastrointestinal endoscopies with multistage esophageal biopsies were prospectively performed in 63 adolescents with EA. A standardized form was used to collect clinical and endoscopic data. Diagnosis of EoE was made as ≥15 intraepithelial eosinophils/high power field, whatever the response on proton pump inhibitors therapy.
Six patients (9.5%) presented an EoE (17-100 eosinophils/high power field). An atopic condition was reported more frequently in the eosinophil ≥15 group than in patients with no EoE (66% vs 16%; P = 0.014). Except for chest pain, symptoms and endoscopic features were similar in patients with EoE and patients with no EoE.
In our series of 63 patients born with EA, mainly distal tracheoesophageal fistula, the prevalence of EoE is increased, and therefore should be considered in adolescents with EA.
嗜酸性食管炎（EoE）是一种日益被认识的儿童疾病。食管闭锁（EA）是食管最常见的先天性畸形。最近，有报道称在患有 EA 的患者中出现 EoE，但 EA 中 EoE 的确切患病率尚不清楚。本研究旨在调查青少年 EA 中 EoE 的患病率，并描述这些患者的特征。
对 63 例 EA 青少年进行了前瞻性的上消化道内镜多阶段食管活检。使用标准化表格收集临床和内镜数据。EoE 的诊断标准为≥15 个上皮内嗜酸性粒细胞/高倍视野，无论质子泵抑制剂治疗的反应如何。
6 例（9.5%）患者存在 EoE（17-100 个嗜酸性粒细胞/高倍视野）。在嗜酸性粒细胞≥15 组中，有特应性疾病的报告比例高于无 EoE 的患者（66%比 16%；P=0.014）。除胸痛外，EoE 患者与无 EoE 患者的症状和内镜特征相似。
在我们的 63 例 EA 出生患者系列中，主要是远端气管食管瘘，EoE 的患病率增加，因此应考虑在 EA 青少年中考虑 EoE。
