Characteristics and management of eosinophilic esophagitis in Australasian children: a decade of experience.

Autor: Philpott H; Department of Gastroenterology, North Adelaide Local Health Network, Adelaide, South Australia, Australia.; University of Adelaide, Adelaide, South Australia, Australia., Lemberg DA; Paediatrics Department, University of NSW, Sydney Children's Hospital, Sydney, New South Wales, Australia., Day AS; Paediatric Department, University of Otago, Christchurch, New Zealand., Rosenbaum J; Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Melbourne, Victoria, Australia., Singh H; Paediatrics Department, University of NSW, Sydney Children's Hospital, Sydney, New South Wales, Australia.; Department of Gastroenterology, Monash Childrens Hospital, Melbourne, Victoria, Australia., Rumore S; Department of Gastroenterology, Hepatology and Liver Transplantation, Queensland Children's Hospital, Brisbane, Queensland, Australia., Ellison S; Gastroenterology Unit, Women's and Children's Hospital, Adelaide, South Australia, Australia., Couper M; Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Melbourne, Victoria, Australia., Porter J; Paediatric Department, University of Otago, Christchurch, New Zealand., Roberts A; Gastroenterology/Hepatology Service, Starship Children's Hospital, Auckland, New Zealand., Thacker K; Gastroenterology Unit, Perth Children's Hospital, Perth, Western Australia, Australia.; Gastroenterology Department, Westmead Children's Hospital, Sydney, New South Wales, Australia., Moore D; Gastroenterology Unit, Women's and Children's Hospital, Adelaide, South Australia, Australia., Furata G; Digestive Health (Gastroenterology and Hepatology), Children's Hospital Colorado, Aurora, Colorado, USA., Sharma A; Department of Paediatrics, Fiona Stanley Hospital, Perth, Western Australia, Australia.; Joondalup Health Campus, Perth, Western Australia, Australia.; SJOG Midland Hospital and Curtin Medical School, Perth, Western Australia, Australia.; Perth Paediatrics, Perth, Western Australia, Australia.
Jazyk: angličtina
Zdroj: Internal medicine journal [Intern Med J] 2024 Dec 24. Date of Electronic Publication: 2024 Dec 24.
DOI: 10.1111/imj.16558
Abstrakt: Background: The frequency of EoE has been increasing in Northern Hemisphere cohorts, yet there is a scarcity of data in our region. Regional climatic factors, and lifestyle habits may influence the presentation of EoE, and appropriate management is crucial to prevent complications. WIth this is mind we undertook the first comprehensive multisite study of EoE in Australasian children.
Aim: To determine the incidence, prevalence, clinical characteristics and management of eosinophilic esophagitis (EoE) in Australasian children.
Methods: Retrospective audit of endoscopic records, histology reports and case notes (ICD code) over a 10-year period (1 January 2008 to 31 December 2018). Cases were defined as having >15 eosinophils per high-power field (HPF) at endoscopy and oesophageal biopsy, while treatment response was defined as <5 eosinophils per HPF. Included were patients aged 0-18 years presenting to tertiary paediatric hospitals in seven capital cities (Adelaide, Auckland, Brisbane, Christchurch, Melbourne, Perth and Sydney), while those with conditions that could cause eosinophilia (organ transplantation, hyper-eosinophilic syndrome) or taking medications that may influence tissue eosinophilia (systemic corticosteroids immunosuppressants) were excluded. Australian Bureau of Statistics and Stats NZ were used to define comparative population data. Demographics (age at diagnosis, gender, country of birth, race) comorbidities (atopic conditions, e.g. asthma, seasonal rhinitis, eczema) and treatment (diet, steroids, proton pump inhibitors) were noted.
Results: The prevalence of EoE ranged from 15 to 54 per 100 000 children, where cases were more common in Adelaide than other localities. Incidence increased significantly in all sites across the 10 years, with peak incidence in Adelaide of 6.4 per 100 000 children in 2017. EoE was most frequent in males (male:female ratio = 3:1) and >90% were white Caucasian. Polynesian racial background in Auckland (10%) and middle eastern racial background in Sydney (10%) were the next most frequent. Treatment choice varied across sites, and greater than 30% of patients did not undergo endoscopy to assess initial treatment success.
Conclusion: The prevalence of EoE in Australasian children is comparable to that observed elsewhere, and the incidence is increasing significantly. Regional differences in disease frequency, management practices and access to endoscopy warrant further study.
(© 2024 Royal Australasian College of Physicians.)
Databáze: MEDLINE
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