School of Public Health, University of Nevada, Las Vegas, NV, USA.
Department of Pediatrics, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
Dis Esophagus. 2020 May 15;33(5). doi: 10.1093/dote/doz105.
Eosinophilic esophagitis (EoE) is a rare, immune-mediated illness. We aimed to examine the comorbidities and sensitization patterns associated with an EoE diagnosis in Nevada. The study goal was two-fold: to determine the most common EoE comorbidities and sequela in the state of Nevada using healthcare utilization records across all settings and to determine the most common food and aeroallergens in histologically positive EoE pediatric patients using clinical sensitization data. Esophageal obstruction/stricture was the most frequently reported diagnosis in adults with EoE (29.5%). Among pediatrics, the highest ranking comorbidities included asthma (13.4%); diseases of the stomach, duodenum, and intestine (7.26%); allergies (7.01%); and gastroesophageal reflux disease (GERD) (3.69%). Additionally, the top sensitizations reported in histologically positive EoE patients were largely pollen related (82.9%). Atopic disease and specifically food allergens are commonly reported as comorbid conditions with EoE in the literature. However, our clinical pediatric data set from this study revealed that aeroallergen sensitizations far exceeded that of food allergens (82.9% aero-positive vs. 17.1% dood positive). The high presence of esophageal stricture/obstruction in adults could be indicative of late diagnosis; in addition, the aeroallergen sensitization in children could suggest different clinical management techniques necessary may be needed for this disease. Education among healthcare providers regarding the presence of aeroallergen sensitization in this population may result in earlier diagnoses and help reduce morbidity and the cost from this disease.
嗜酸性食管炎（EoE）是一种罕见的免疫介导疾病。我们旨在研究内华达州 EoE 诊断相关的合并症和致敏模式。该研究的目的有两个：一是使用所有设置的医疗保健利用记录确定内华达州最常见的 EoE 合并症和后遗症；二是使用临床致敏数据确定组织学阳性 EoE 儿科患者中最常见的食物和空气过敏原。食管梗阻/狭窄是成人 EoE 最常报告的诊断（29.5%）。在儿科中，排名最高的合并症包括哮喘（13.4%）；胃、十二指肠和肠道疾病（7.26%）；过敏（7.01%）；和胃食管反流病（GERD）（3.69%）。此外，组织学阳性 EoE 患者报告的最高致敏原主要与花粉有关（82.9%）。在文献中，特应性疾病，特别是食物过敏，通常被报道为 EoE 的合并症。然而，我们从这项研究中获得的临床儿科数据集显示，空气过敏原致敏率远远高于食物过敏原致敏率（82.9%空气阳性与 17.1%食物阳性）。成人中食管狭窄/梗阻的高发生率可能表明诊断较晚；此外，儿童中空气过敏原致敏可能表明需要为这种疾病采用不同的临床管理技术。提高医疗保健提供者对该人群中空气过敏原致敏的认识，可能会导致更早的诊断，并有助于减少这种疾病的发病率和医疗费用。
