ORIGINAL PAPER
Clinical features of eosinophilic oesophagitis in Polish paediatric patients: a single-centre retrospective study
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1
Faculty of Medical Sciences in Zabrze, Students Association, Medical University of Silesia, Katowice, Poland
2
Department of Paediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
3
Clinical Hospital No. 1, Zabrze, Poland
These authors had equal contribution to this work
Submission date: 2025-04-07
Final revision date: 2025-06-24
Acceptance date: 2025-07-22
Publication date: 2025-09-24
Corresponding author
Katarzyna Górowska-Kowolik
Dr. Katarzyna Górowska-Kowolik, Department of Paediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
Pediatr Pol 2025;61(3):223-228
KEYWORDS
TOPICS
ABSTRACT
Introduction:
To assess the clinical picture, risk factors and epidemiology of eosinophilic oesophagitis (EoE) in the Polish paediatric population.
Material and methods:
A retrospective analysis of the medical data of patients hospitalised at the Department of Paediatric Gastroenterology and Hepatology of the First Independent Public Teaching Hospital in Zabrze during the years 2016–2023 was performed. The study included 40 children, aged 1–16 years, who met the criteria for EoE diagnosis, including 7 female and 33 male patients (17.5% vs. 82.5%, p < 0.001).
Results:
The disease prevalence was significantly higher in the male patients and during puberty. As many as 67.5% of the children with EoE revealed other allergic diseases, most commonly bronchial asthma, while among the comorbidities of non-allergic origin gastroesophageal reflux had a significant prevalence rate (25%). The most commonly reported symptoms included abdominal pain and dysphagia with food sticking in the oesophagus (dysphagia). Half of the patients presented at least one symptom that could have suggested gastro-oesophageal reflux disease (GORD). The median time from symptom onset to diagnosis was 24 months. EoE was diagnosed earlier in patients with the dysphagia symptom. In children with regurgitation, the time from symptom onset to diagnosis was significantly longer. Over the last two years of observation, an increased incidence of EoE was reported compared to previous study periods.
Conclusions:
The incidence rates of EoE have been increasing in recent years. In the study material, male patients and children in puberty were identified as a risk group for this condition. GORD was the most common non-allergic comorbidity of EoE, and half of the patients diagnosed with EoE presented symptoms indicative of GORD. At the same time, the occurrence of regurgitation was considered an independent factor delaying the diagnosis of EoE. Therefore, patients with symptoms of gastro-oesophageal reflux should be actively assessed for possible coexistence of EoE.
REFERENCES (33)
1.
Landres RT, Kuster GG, Strum WB. Eosinophilic esophagitis in a patient with vigorous achalasia. Gastroenterology 1978; 74: 1298-1301.
2.
Arias Á, Lucendo AJ. Incidence and prevalence of eosinophilic oesophagitis increase continiously in adults and children in Central Spain: a 12-year population-based study. Dig Liver Dis 2019; 51: 55-62.
3.
Allin KH, Poulsen G, Melgaard D, et al. Eosinophilic oesophagitis in Denmark: population-based incidence and prevalence in a nationwide study from 2008 to 2018. United European Gastroenterol J 2022; 10: 640-650.
4.
Votto M, Raffaele A, De Filippo M, et al. Eosinophilic gastrointestinal disorders in children and adolescents: a single-center experience. Dig Liver Dis 2022; 54: 214-220.
5.
Votto M, De Filippo M, Caimmi S, et al. A practical update on pediatric eosinophilic esophagitis. Children (Basel) 2023; 10: 1620. DOI: 10.3390/children10101620.
6.
Dellon ES, Hirano I. Epidemiology and natural history of eosinophilic esophagitis. Gastroenterology 2018; 154: 319-332.e3. DOI: 10.1053/j.gastro.2017.06.067.
7.
Dellon ES, Liacouras CA, Molina-Infante J, et al. Updated international consensus diagnostic criteria for eosinophilic esophagitis: proceedings of the AGREE conference. Gastroenterology 2018; 155: 1022-1033.e10. DOI: 10.1053/j.gastro.2018.07.009.
8.
Votto M, Marseglia GL, De Filippo M, et al. Early life risk factors in pediatric EoE: could we prevent this modern disease? Front Pediatr 2020; 8: 263. DOI: 10.3389/fped.2020.00263.
9.
Celebi Sozener Z, Ozdel Ozturk B, Cerci P, et al. Epithelial barrier hypothesis: effect of the external exposome on the microbiome and epithelial barriers in allergic disease. Allergy 2022; 77: 1418-1449.
10.
Ruffner MA, Kennedy K, Cianferoni A. Pathophysiology of eosinophilic esophagitis: recent advances and their clinical implications. Expert Rev Clin Immunol 2019; 15: 83-95.
11.
Votto M, Lenti MV, De Silvestri A, et al. Evaluation of diagnostic time in pediatric patients with eosinophilic gastrointestinal disorders according to their clinical features. Ital J Pediatr 2023; 49: 9. DOI: 10.1186/s13052-023-01410-1.
12.
Matteis AD, Pagliaro G, Corleto VD, et al. Eosinophilic esophagitis in children: clinical findings and diagnostic approach. Curr Pediatr Rev 2020; 16: 206-214.
13.
Hahn JW, Lee K, Shin JI, et al. Global incidence and prevalence of eosinophilic esophagitis, 1976-2022: a systematic review and meta- analysis. Clin Gastroenterol Hepatol 2023; 21: 3270-3284.e77. DOI: 10.1016/j.cgh.2023.06.005.
14.
de Rooij WE, Barendsen ME, Warners MJ, et al. Emerging incidence trends of eosinophilic esophagitis over 25 years: results of a nationwide register-based pathology cohort. Neurogastroenterol Motil 2021; 33: e14072. DOI: 10.1111/nmo.14072.
15.
Gómez AR, Ortega SF, Cañas AP, et al. Impact of environmental factors on the epidemiology of eosinophilic esophagitis in southwestern Europe (2007-2020). J Allergy Clin Immunol Glob 2023; 2: 100088. DOI: 10.1016/j.jacig.2023.100088.
16.
Moawad FJ, Veerappan GR, Lake JM, et al. Correlation between eosinophilic oesophagitis and aero-allergens. Aliment Pharmacol Ther 2010; 31: 509-515.
17.
Lucendo AJ, Arias A, Redondo-Gonzalez O, Gonzalez-Cervera J. Seasonal distribution of initial diagnosis and clinical recrudescence of eosinophilic esophagitis: a systematic review and meta-analysis. Allergy 2015; 70: 1640-1650.
18.
Cianferoni A, Jensen E, Davis CM. The role of the environment in eosinophilic esophagitis. J Allergy Clin Immunol Pract 2021; 9: 3268-3274.
19.
Mehta P, Pan Z, Zhou W, et al. Examining disparities in pediatric eosinophilic esophagitis. J Allergy Clin Immunol Pract 2023; 11: 2855-2859.
20.
Laserna-Mendieta EJ, Navarro P, Casabona-Francés S, et al. Differences between childhood- and adulthood-onset eosinophilic esophagitis: an analysis from the EoE connect registry. Digest Liver Dis 2023; 55: 350-359.
21.
Zdanowicz K, Kucharska M, Sobaniec-Lotowska ME, et al. Eosinophilic esophagitis in children in North-Eastern Poland. J Clin Med 2020; 9: 3869. DOI: 10.3390/jcm9123869.
22.
Weerasekera K, Sim D, Coughlan F, et al. Eosinophilic esophagitis incidence in New Zealand: high but not increasing. Clin Exp Gastroenterol 2019; 12: 367-374.
23.
Pinheiro MIC, de Góes Cavalcanti LP, Honório RS, et al. Eosinophilic esophagitis in Brazilian pediatric patients. Clin Med Insights Pediatr 2013; 7: 41-48.
24.
Kia L, Hirano I. Distinguishing GORD from eosinophilic oesophagitis: concepts and controversies. Nat Rev Gastroenterol Hepatol 2015; 12: 379-386.
25.
Ristic N, Jankovic R, Dragutinovic N, et al. Diagnosis of eosinophilic esophagitis in children: a Serbian single-center experience from 2010 to 2017. Med Princ Pract 2019; 28: 449-456.
26.
Amil-Dias J, Oliva S, Papadopoulou A, et al. Diagnosis and management of eosinophilic esophagitis in children: an update from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr 2024; 79: 394-437.
27.
Calabrese C, Fabbri A, Bortolotti M, et al. Dilated intercellular spaces as a marker of oesophageal damage: comparative results in gastro- oesophageal reflux disease with or without bile reflux. Aliment Pharmacol Ther 2003; 18: 525-532.
28.
Cheng L, Harnett KM, Cao W, et al. Hydrogen peroxide reduces lower esophageal sphincter tone in human esophagitis. Gastroenterology 2005; 129: 1675-1685.
29.
Muñoz FV, Almeida PH, Carrión-Jaramillo E, et al. Clinical features of eosinophilic esophagitis: a single center experience in Ecuador. Pediatr Gastroenterol Hepatol Nutr 2022; 25: 293-299.
30.
Capucilli P, Hill DA. Allergic comorbidity in eosinophilic esophagitis: mechanistic relevance and clinical implications. Clin Rev Allergy Immunol 2019; 57: 111-127.
31.
Williamson P, Aceves S. Allergies and eosinophilic esophagitis – current updates for the pediatric gastroenterologist. Curr Gastroenterol Rep 2019; 21: 56. DOI: 10.1007/s11894-019-0729-y.
32.
Kelly KJ, Lazenby AJ, Rowe PC, et al. Eosinophilic esophagitis attributed to gastroesophageal reflux: Improvement with an amino acid-based formula. Gastroenterology 1995; 109: 1503-1512.
33.
Hill DA, Grundmeier RW, Ramos M, et al. Eosinophilic esophagitis is a late manifestation of the allergic march. J Allergy Clin Immunol Pract 2018; 6: 1528-1533.