Azzano Pauline, Villard Truc Florence, Collardeau-Frachon Sophie, Lachaux Alain
Service d'Hépatologie, Gastroentérologie et Nutrition pédiatriques, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, France.
Service d'Hépatologie, Gastroentérologie et Nutrition pédiatriques, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, France.
Allergol Immunopathol (Madr). 2020 May-Jun;48(3):244-250. doi: 10.1016/j.aller.2019.07.013. Epub 2019 Dec 6.
Eosinophilic esophagitis (EoE) is frequently miss-diagnosed or overlooked for several years because of the invasiveness of investigations and the non-specificity of symptoms in childhood. Due to the lack of specific recommendations in children, its management remains very heterogeneous, especially concerning allergy testing. The aim of this study is to analyze our population and practices, in comparison with the literature, with a focus on allergic management, to harmonize and optimize our practice.
We included all children with a diagnosis of EoE at the Hospital Femme Mere Enfant, Bron, France. Data were collected via retrospective chart review.
108 patients were included with an average age of 9.5 years. Average delay before diagnosis was 6.65 years. Symptoms varied with age, with a predominance of vomiting (60% of patients), feeding difficulties (72%) and growth difficulties (24%) in children <5 years, whereas older children often presented with feeding blockage (64%) and dysphagia (61%). Cough was frequent in our cohort (18.5%), especially in children <10 years (38.5% between three and five years). The allergic background was frequent (70.3%) and 80% of our patients benefited from allergy testing. Allergy testing was particularly useful to guide therapy as elimination diet represented an effective treatment in 60% of our patients CONCLUSIONS: Allergy testing has to be harmonized to include major allergens (egg, milk, peanut, fish, wheat, and soy), including prick and patch tests. Allergy-testing based diet seemed to be the best compromise between efficiency and constraints, especially in mono-sensitized patients.
由于儿童时期检查的侵入性以及症状的非特异性，嗜酸性粒细胞性食管炎（EoE）经常被误诊或多年来被忽视。由于儿童缺乏具体的建议，其治疗仍然非常多样化，尤其是在过敏检测方面。本研究的目的是与文献相比，分析我们的人群和实践，重点关注过敏管理，以协调和优化我们的实践。
我们纳入了法国布龙市妇幼医院所有诊断为EoE的儿童。数据通过回顾性病历审查收集。
纳入108例患者，平均年龄9.5岁。诊断前的平均延迟时间为6.65年。症状随年龄而异，5岁以下儿童中呕吐（60%的患者）、喂养困难（72%）和生长困难（24%）占主导，而年龄较大的儿童常出现喂食梗阻（64%）和吞咽困难（61%）。咳嗽在我们的队列中很常见（18.5%），尤其是在10岁以下的儿童中（3至5岁之间为38.5%）。过敏背景很常见（70.3%），80%的患者接受了过敏检测。过敏检测对指导治疗特别有用，因为排除饮食在60%的患者中是一种有效的治疗方法。结论：必须统一过敏检测，包括主要过敏原（鸡蛋、牛奶、花生、鱼、小麦和大豆），包括点刺试验和斑贴试验。基于过敏检测的饮食似乎是效率和限制之间的最佳折衷方案，尤其是在单敏患者中。
