EN
TÜRKÇE
Oral Presentation - 24
Characterization of Eosinophilic Esophagitis in Patients with Esophageal Atresia: A Multicenter International Study
M Aumar*, U Krishnan**, H Mousa***, M Antoine*, C Faure****, M Veira*****, R Tambucci******, L Maria Antoniello*******, J Svensson********, A Koivusalo*********, K Katileta**********, M van Wijk***********, Ç Ulukaya Durakbaşa************, S Oliva*************, S Vandevelde**************, N Zevit***************, R Nassar****************, T Soyer*****************, N Thapar******************, H Hölz*******************, C Tzivinikos********************, S Husby*********************, V Urbonas**********************, F Çullu Çokuğraş***********************, MdC Espinheira************************, A Papadopoulou*************************, L Mortain**************************, M Leroy*, F Gottrand*
*Service de gastroentérologie, hépatologie et nutrition pédiatriques, Lille Hospital, Lille Cedex, France
**Sydney children's Hospital, Sydney, Australia
***The Children's Hospital of Philadelphia, Philadelphia, United States of America
****Sainte Justine Hospital, Montreal, Canada
*****Hospital Pequeno Príncipe, Curitiba, Brazil
******Ospedale Pediatrico Bambino Gesù, Roma, Italy
*******Azienda Ospedale Università, Padova, Italy
********Karolinska University Hospital, Stockholm, Sweden
*********Helsinki University Central Hospital, Helsinki, Finland
**********Hôpital Universitaire de Bruxelles, Bruxelles, Belgium
***********Emma Children's hospital, Amsterdam, Netherlands
************Istanbul Medeniyet Üniversitesi, Istanbul, Turkey
*************Policlinico Umberto I - Sapienza Università di Roma, Roma, Italy
**************UZ Ghent, Ghent, Belgium
***************Schneider Children's Medical Center of Israel, Petah Tikva, Israel
****************Pediatric Gastroenterology, Hepatology, and Nutrition Unit, Soroka University Medical Center, Beer Sehva, Israel
*****************Hacettepe University School of Medicine, Ankara, Turkey
******************Children’s Health Queensland Hospital and Health Service, South Brisbane, Australia
*******************Dr. von Hauner Children´s Hospital, München, Germany
********************Aljalial children's specialty hospital, DUbai, United Arab Emirates
*********************Odense University hospital, Odense, Denmark
**********************Vilnius University Hospital Santariskiu Klinikos - Childrens Hospital, Vilnius, Lithuania
***********************İstanbul Üniversitesi-Cerrahpaşa, Istabul, Turkey
************************Centro Hospitalar Universitário São João, Porto, Portugal
*************************Children's Hospital Agia Sofia, Athens, Greece
**************************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.