Tincu Iulia Florentina, Bordei Luiza Elena, Gales Lucica Luminita, Duchi Larisa Alexandra, Dobrescu Loredana, Chenescu Bianca Teodora
Department of Paediatrics, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Gastroenterology Department, "Dr. Victor Gomoiu" Clinical Children Hospital, 022102 Bucharest, Romania.
J Clin Med. 2024 Aug 25;13(17):5041. doi: 10.3390/jcm13175041.
An increase in the incidence of eosinophilic esophagitis (EoE) in children has been reported worldwide in the last decade. We conducted a study in a tertiary pediatric gastroenterology unit aimed at analyzing the clinical manifestations, biochemical markers, and endoscopic features of children with EoE in comparison to patients with non-eosinophilic esophagitis. : This is a prospective analysis involving children with symptoms related to esophageal dysfunction, who had esophagogastroduodenoscopies with esophageal biopsies between January 2021 and April 2024 at "Dr. Victor Gomoiu" Clinical Children's Hospital, in Bucharest, Romania. For the analysis, patients were considered in either Group 1, classified as EoE, or in Group 2, classified as reflux esophagitis. : Among the total of 72 patients diagnosed with esophagitis, 17 patients (Group 1-study group) were classified as EoE and 55 were classified as reflux esophagitis (Group 2-control group). The sex ratio analysis showed a male predominance in the study group (71% vs. 32%, = 0.002). The main symptoms were regurgitation, eructation, and nausea. Dysphagia was present in two (11.76%) patients from Group 1. Eosinophilia was more prevalent in the EoE group than in the individuals with gastroesophageal reflux disease (GERD) (10 (58.85%) vs. 10 (18.18%, = 0.001)), as well as the total IgE (11 (64.70%) vs. 6 (10.9%, = 0.001)). Pediatric gastroenterologists need to be aware of EoE atypical presentation and perform adequate biopsies, mainly in children with refractory GERD-like symptoms, dysphagia, and food bolus impaction. Further analyses in terms of prognosis and treatment response should be addressed in longitudinal studies.
在过去十年中，全球范围内均有报道称儿童嗜酸性食管炎（EoE）的发病率有所上升。我们在一家三级儿科胃肠病科进行了一项研究，旨在分析EoE患儿与非嗜酸性食管炎患者相比的临床表现、生化指标和内镜特征。这是一项前瞻性分析，研究对象为有食管功能障碍相关症状的儿童，他们于2021年1月至2024年4月在罗马尼亚布加勒斯特的“维克托·戈莫尤博士”临床儿童医院接受了食管胃十二指肠镜检查及食管活检。在分析时，患者被分为两组，第1组被归类为EoE，第2组被归类为反流性食管炎。在总共72例被诊断为食管炎的患者中，17例患者（第1组——研究组）被归类为EoE，55例被归类为反流性食管炎（第2组——对照组）。性别比例分析显示研究组以男性为主（71%对32%，P = 0.002）。主要症状为反流、嗳气和恶心。第1组中有两名（11.76%）患者出现吞咽困难。嗜酸性粒细胞增多症在EoE组比在胃食管反流病（GERD）患者中更普遍（10例（58.85%）对10例（18.18%），P = 0.001），总IgE也是如此（11例（64.70%）对6例（10.9%），P = 0.001）。儿科胃肠病学家需要意识到EoE的非典型表现，并进行充分的活检，主要针对有难治性GERD样症状、吞咽困难和食物团块嵌塞的儿童。关于预后和治疗反应的进一步分析应在纵向研究中进行探讨。
