Weill Cornell Medicine, New York, NY, USA.
Division of Pediatric Gastroenterology and Nutrition, NY Presbyterian Hospital, New York, NY, USA.
Pediatr Allergy Immunol. 2020 Oct;31(7):835-840. doi: 10.1111/pai.13297. Epub 2020 Jun 17.
Nutritional deficiencies are seen in patients with food allergy. Low vitamin D levels have been found in patients with atopic conditions. Eosinophilic esophagitis (EoE) is a chronic immune antigen-mediated disease found to be highly associated in patients with atopic disease and treated with dietary elimination with recommendations to utilize a dietician to prevent nutritional deficiencies. Nonetheless, the relationship between EoE and vitamin deficiency remains unclear. We aimed to systematically review the evidence to support a possible association between vitamin deficiency and eosinophilic esophagitis.
Electronic searches were performed with keywords relating to EoE and vitamins among pediatric patients in MEDLINE, EMBASE, and The Cochrane Library. Summary estimates were calculated. Citations were reviewed against pre-defined criteria. (Inclusion: human subjects, aged 0-18, with eosinophilic esophagitis. Exclusion: adults over 18 years, non-English papers).
The search yielded 1707 studies. Five of these studies with a total of 137 pediatric patients were included in the systematic review. Outcome measures were assessed at different points in EoE treatment across studies. The single common outcome measure across all included studies was vitamin D. Reported prevalence of low vitamin D varied in these studies (0%-52%). Vitamin D levels of children with EoE both pre- and post-intervention were low.
There is limited published literature on vitamin deficiencies associated with EoE both pre- and post-intervention. The limited data on vitamin D suggest that insufficiency or deficiency may be present in these patients, but it remains unclear whether deficiency is caused by diet. More prospective, well-defined studies, in addition to routine reporting on dietary intake and nutritional status, are needed to make any conclusions or recommendations for screening.
食物过敏患者会出现营养缺乏。特应性疾病患者的维生素 D 水平较低。嗜酸性粒细胞性食管炎（EoE）是一种慢性免疫抗原介导的疾病，与特应性疾病高度相关，治疗方法是饮食消除，并建议使用营养师来预防营养缺乏。然而，EoE 与维生素缺乏之间的关系仍不清楚。我们旨在系统地回顾证据，以支持维生素缺乏与嗜酸性粒细胞性食管炎之间可能存在关联。
使用与儿科患者 EoE 和维生素相关的关键字在 MEDLINE、EMBASE 和 The Cochrane Library 中进行电子搜索。计算汇总估计值。根据预先定义的标准对引用进行审查。（纳入标准：人类受试者，年龄 0-18 岁，患有嗜酸性粒细胞性食管炎。排除标准：18 岁以上的成年人，非英语论文）。
搜索结果产生了 1707 项研究。其中五项研究共纳入了 137 名儿科患者，纳入了系统评价。研究在不同的 EoE 治疗阶段评估了结果测量。所有纳入研究的唯一共同结果测量是维生素 D。这些研究中报告的低维生素 D 患病率各不相同（0%-52%）。患有 EoE 的儿童的维生素 D 水平无论是在干预前还是干预后都较低。
关于干预前后与 EoE 相关的维生素缺乏症，发表的文献有限。关于维生素 D 的有限数据表明，这些患者可能存在不足或缺乏，但仍不清楚缺乏是否是由饮食引起的。需要更多前瞻性、明确的研究，以及对饮食摄入和营养状况的常规报告，才能得出任何结论或建议进行筛查。
