EN
TÜRKÇE
Oral Presentation - 23
Characterization of Eosinophilic Esophagitis in Patients with Esophageal Atresia: A Multicenter International Study
M Aumar 1, U Krishnan 2, H Mousa 3, M Antoine 1, C Faure 4, M Veira 5, R Tambucci 6, L Maria Antoniello 7, J Svensson 8, A Koivusalo 9, K Katileta 10, M van Wijk 11, Ç Ulukaya Durakbaşa 12, S Oliva 13, S Vandevelde 14, N Zevit 15, R Nassar 16, T Soyer 17, N Thapar 18, H Hölz 19, C Tzivinikos 20, S Husby 21, V Urbonas 22, F Çullu Çokuğraş 23, MdC Espinheira 24, A Papadopoulou 25, L Mortain 26, M Leroy 1, F Gottrand 1
1 Service de gastroentérologie, hépatologie et nutrition pédiatriques, Lille Hospital, Lille Cedex, France
2 Sydney children's Hospital, Sydney, Australia
3 The Children's Hospital of Philadelphia, Philadelphia, United States of America
4 Sainte Justine Hospital, Montreal, Canada
5 Hospital Pequeno Príncipe, Curitiba, Brazil
6 Ospedale Pediatrico Bambino Gesù, Roma, Italy
7 Azienda Ospedale Università, Padova, Italy
8 Karolinska University Hospital, Stockholm, Sweden
9 Helsinki University Central Hospital, Helsinki, Finland
10 Hôpital Universitaire de Bruxelles, Bruxelles, Belgium
11 Emma Children's hospital, Amsterdam, Netherlands
12 Istanbul Medeniyet Üniversitesi, Istanbul, Turkey
13 Policlinico Umberto I - Sapienza Università di Roma, Roma, Italy
14 UZ Ghent, Ghent, Belgium
15 Schneider Children's Medical Center of Israel, Petah Tikva, Israel
16 Pediatric Gastroenterology, Hepatology, and Nutrition Unit, Soroka University Medical Center, Beer Sehva, Israel
17 Hacettepe University School of Medicine, Ankara, Turkey
18 Children’s Health Queensland Hospital and Health Service, South Brisbane, Australia
19 Dr. von Hauner Children´s Hospital, München, Germany
20 Aljalial children's specialty hospital, DUbai, United Arab Emirates
21 Odense University hospital, Odense, Denmark
22 Vilnius University Hospital Santariskiu Klinikos - Childrens Hospital, Vilnius, Lithuania
23 İstanbul Üniversitesi-Cerrahpaşa, Istabul, Turkey
24 Centro Hospitalar Universitário São João, Porto, Portugal
25 Children's Hospital Agia Sofia, Athens, Greece
26 Lille Hospital, Lille Cedex, France
An increased prevalence of eosinophilic esophagitis (EoE) has been observed in patients with esophageal atresia (EA), but precise phenotyping is lacking. This study aimed to better understand this association by examining the clinical presentation and outcomes of EA patients with EoE, comparing them to those with isolated EoE and EA without EoE.
A dedicated database was created, including 264 cases of EoE in EA patients from 25 centers worldwide, with data on patient demographics and symptoms at diagnosis, and treatment. These patients were compared to 907 patients with isolated EoE from the pEEr registry, and to 361 EA patients without EoE from the COMAD6 cohort.
The EA/EoE cohort had a mean age of 4±4 years at diagnosis (66% boys, 54% allergic history). Fifty-eight percent were on PPIs at diagnosis, 61% had recurrent anastomotic strictures. Presenting symptoms included dysphagia (58%), feeding difficulties (55%), and vomiting (40%). Endoscopy showed abnormalities in 81% of cases, with strictures (54%) and edema (32%) being most common.
Treatment was initiated in 88% of cases, with PPIs (53%) and topical corticosteroids (27%). At follow-up, endoscopic improvements were noted (p<0.001), and eosinophil counts decreased (p<0.001). Thirty-three percent of patients had a complete histological response, 24% had a partial response. The mean annual number of strictures requiring dilation was significantly lower post-treatment (p<0.001).
Compared to patients with isolated EoE, those with EoE/EA were significantly younger, less often male, and had fewer allergies. The EoE/EA group also presented more long-gap EA and more frequent recurrent fistulas and gastrostomy placements.
This study highlights that EoE in EA patients has distinct characteristics, including early diagnosis, and a higher prevalence on long gap EA with a worse phenotype underscoring the importance of early diagnosis and treatment of EoE in the EA cohort.