To the Editor: Eosinophilic gastrointestinal diseases (EGIDs) are rare disorders causing long-term complications in children, if left untreated. They comprise eosinophilic esophagitis (EoE), eosinophilic gastritis, eosinophilic enteritis, and eosinophilic colitis [1, 2]. EoE is the most common and best described EGID [3]. The aim of this study was to evaluate the effectiveness of current management practices and identify possible prognostic factors of the disease.
A retrospective study was conducted from January 2019 to December 2020. All patients diagnosed with EGID were enrolled. A form was used to collect clinical, endoscopic, and histological data. Patients were divided into two groups: (a) children with EoE, and (b) children with EGID beyond EoE (EGIDBEoE). They were followed up for at least 1 y. Outcome was the response to treatment [elimination diet, proton pump inhibitors (PPIs), topical swallowed budesonide, combination treatment], defined as clinical, endoscopic, and histological remission. Disease control level was classified as fully controlled, partially controlled, and uncontrolled [4].
During the study period, 40 children were enrolled. Clinical remission was achieved in the vast majority of the children (92.5%), whereas endoscopic and histological remission was achieved in 72.5% and 57.5% of the cases, respectively. Among the different types of treatment, PPI monotherapy was the most effective treatment regarding symptom relief (27.5%), and endoscopic (27.5%) and histological remission (17.5%). Children suffering from EoE presented better disease control, compared to those with EGIDBEoE (p = 0.03). The use of combination treatment (odds ratio: 7.5, confidence interval: 1.6–35, p = 0.01) and disease subtype of EoE (odds ratio: 5.34, confidence interval: 1.26–22.52, p = 0.02) were positive prognostic factors for histological remission achievement.
Although resolution of clinical symptoms seems to be achieved in most children with current treatment options, future studies should focus on developing effective treatments for the histological remission of the disease, which is the main therapeutic goal, and the optimal management of children with EGIDBEoE.
References
Gonsalves N. Eosinophilic gastrointestinal disorders. Clin Rev Allergy Immunol. 2019;57:272–85.
Dellon ES, Gonsalves N, Abonia JP, et al. International consensus recommendations for eosinophilic gastrointestinal disease nomenclature. Clin Gastroenterol Hepatol. 2022;S1542–3565:00143–4.
Steinbach EC, Hernandez M, Dellon ES. Eosinophilic esophagitis and the eosinophilic gastrointestinal diseases: approach to diagnosis and management. J Allergy Clin Immunol Pract. 2018;6:1483–95.
Egritas Gurkan O, Ozturk H, Karagol HIE, et al. Primary eosinophilic gastrointestinal diseases beyond eosinophilic esophagitis in children. J Pediatr Gastroenterol Nutr. 2021;72:294–9.
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Dimopoulou, A., Dimopoulou, D., Papakonstantinou, D. et al. Eosinophilic Gastrointestinal Diseases in Children: Prognostic Factors and Outcomes. Indian J Pediatr 89, 923 (2022). https://doi.org/10.1007/s12098-022-04291-0
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DOI: https://doi.org/10.1007/s12098-022-04291-0