CLINICAL AND MORPHOLOGICAL CHARACTERISTICS OF EOSINOPHILIC ESOPHAGITIS IN CHILDREN: A COHORT STUDY

Abstract

Number of children with eosinophilic esophagitis (EoE) observed has recently increased, therefore significant experience has been gained in the diagnosis and treatment of this disease. However, the systemic data from Russian pediatric centers’ registers that would summarize the signs of the disease in childhood has not been published as yet. The purpose of this research was to study the demographic, clinical, endoscopic and morphological features of EoE in children and to form the unified register of patients on the basis of a single yet multidisciplinary pediatric hospital. Materials and methods used: a single-center retrospective cohort study included 50 pediatric (under the age of 18 y/o) patients’ (13 (26%) girls/37 (74%) boys) records of those who were included in the National Medical Research Center for Children’s Health (Moscow, Russia) Register of EoE patients in July 2020-May 2023. Demographic indicators were assessed as well as the clinical manifestations, endoscopic and morphological changes and concomitant diseases. Results: the median age of children at the time of the diagnosis onset was 12 (8; 15) y/o. The age and the gender characteristics of patients were typical for the disease: boys aged 11 to 17 y/o had prevailed. The frequency of the EoE detection among children who had underwent esophagogastroduodenoscopy (EGD test) for various reasons was a single case per 253 EGD tests (0.4%). Among the clinical manifestations, dysphagia (44%) and abdominal pain (70%) were noted more often; GERD-like symptoms and poor weight gain were less common. The vast majority of children (84%) had concomitant allergic pathologies. EoE had proceeded comorbidly with other diseases in 60% of cases. Endoscopic manifestations of EoE were described and analyzed in detail. Thus, swelling of the mucous membrane, longitudinal striation and exudate had prevailed. Complicated course of EoE with the formation of esophageal stenosis was noted in 14%. There were no statistically significant differences between the age groups of children aged 1 to 10 y/o and 11 to 17 y/o in relation to clinical manifestations, endoscopic and morphological characteristics of EoE. Conclusion: thorough registration of pediatric patients with EoE does allow studying and summarizing of the features of this disease, in detail, with further provision of the useful information for clinical practice.