Esophageal Eosinophilia and Eosinophilic Esophagitis in Celiac Children: A Ten Year Prospective Observational Study
The association between eosinophilic esophagitis and celiac disease is still controversial and its prevalence is highly variable. We aimed to investigate the prevalence of esophageal eosinophilia and eosinophilic esophagitis in a large group of children with celiac disease, prospectively followed ov...
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MDPI AG
2021-10-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/13/11/3755 |
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| author | Fernanda Cristofori Fulvio Salvatore D’Abramo Vincenzo Rutigliano Vanessa Nadia Dargenio Stefania Castellaneta Domenico Piscitelli Davide De Benedittis Flavia Indrio Lidia Celeste Raguseo Michele Barone Ruggiero Francavilla |
| author_facet | Fernanda Cristofori Fulvio Salvatore D’Abramo Vincenzo Rutigliano Vanessa Nadia Dargenio Stefania Castellaneta Domenico Piscitelli Davide De Benedittis Flavia Indrio Lidia Celeste Raguseo Michele Barone Ruggiero Francavilla |
| author_sort | Fernanda Cristofori |
| collection | DOAJ |
| description | The association between eosinophilic esophagitis and celiac disease is still controversial and its prevalence is highly variable. We aimed to investigate the prevalence of esophageal eosinophilia and eosinophilic esophagitis in a large group of children with celiac disease, prospectively followed over 11 years. Methods: Prospective observational study performed between 2008 and 2019. Celiac disease diagnosis was based on ESPGHAN criteria. At least four esophageal biopsies were sampled in patients who underwent endoscopy. The presence of at least 15 eosinophils/HPF on esophageal biopsies was considered suggestive of esophageal eosinophilia; at the same time, eosinophilic esophagitis was diagnosed according to the International Consensus Diagnostic Criteria for Eosinophilic Esophagitis. Results: A total of 465 children (M 42% mean age 7.1 years (range: 1–16)) were diagnosed with celiac disease. Three hundred and seventy patients underwent endoscopy, and esophageal biopsies were available in 313. The prevalence of esophageal eosinophilia in children with celiac disease was 1.6% (95% CI: 0.54–2.9%). Only one child was diagnosed as eosinophilic esophagitis; we calculated a prevalence of 0.3% (95% CI: 0.2–0.5%). The odds ratio for an association between eosinophilic esophagitis and celiac disease was at least 6.5 times higher (95% CI: 0.89–47.7%; <i>p</i> = 0.06) than in the general population. Conclusion: The finding of an increased number of eosinophils (>15/HPF) in celiac patients does not have a clinical implication or warrant intervention, and therefore we do not recommend routine esophageal biopsies unless clinically indicated. |
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| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T05:12:19Z |
| publishDate | 2021-10-01 |
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| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-e7b5fe56fdce47ebb4dcbbd54a2d8f152023-11-23T00:45:25ZengMDPI AGNutrients2072-66432021-10-011311375510.3390/nu13113755Esophageal Eosinophilia and Eosinophilic Esophagitis in Celiac Children: A Ten Year Prospective Observational StudyFernanda Cristofori0Fulvio Salvatore D’Abramo1Vincenzo Rutigliano2Vanessa Nadia Dargenio3Stefania Castellaneta4Domenico Piscitelli5Davide De Benedittis6Flavia Indrio7Lidia Celeste Raguseo8Michele Barone9Ruggiero Francavilla10Interdisciplinary Department of Medicine, Pediatric Section “B. Trambusti”, University of Bari “Aldo Moro”, Via Amendola 207, 70126 Bari, ItalyDepartment of Emergency and Organ Transplantation, Section of Gastroenterology, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, ItalyInterdisciplinary Department of Medicine, Pediatric Section “B. Trambusti”, University of Bari “Aldo Moro”, Via Amendola 207, 70126 Bari, ItalyInterdisciplinary Department of Medicine, Pediatric Section “B. Trambusti”, University of Bari “Aldo Moro”, Via Amendola 207, 70126 Bari, ItalyInterdisciplinary Department of Medicine, Pediatric Section “B. Trambusti”, University of Bari “Aldo Moro”, Via Amendola 207, 70126 Bari, ItalyDepartment of Emergency and Organ Transplantation, Section of Pathology, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, ItalyDepartment of Information Engineering, University of Pisa, Largo L. Lazzarino 2, 56122 Pisa, ItalyDepartment of Medical and Surgical Science, University of Foggia, Viale L. Pinto, 71122 Foggia, ItalyInterdisciplinary Department of Medicine, Pediatric Section “B. Trambusti”, University of Bari “Aldo Moro”, Via Amendola 207, 70126 Bari, ItalyDepartment of Emergency and Organ Transplantation, Section of Gastroenterology, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, ItalyInterdisciplinary Department of Medicine, Pediatric Section “B. Trambusti”, University of Bari “Aldo Moro”, Via Amendola 207, 70126 Bari, ItalyThe association between eosinophilic esophagitis and celiac disease is still controversial and its prevalence is highly variable. We aimed to investigate the prevalence of esophageal eosinophilia and eosinophilic esophagitis in a large group of children with celiac disease, prospectively followed over 11 years. Methods: Prospective observational study performed between 2008 and 2019. Celiac disease diagnosis was based on ESPGHAN criteria. At least four esophageal biopsies were sampled in patients who underwent endoscopy. The presence of at least 15 eosinophils/HPF on esophageal biopsies was considered suggestive of esophageal eosinophilia; at the same time, eosinophilic esophagitis was diagnosed according to the International Consensus Diagnostic Criteria for Eosinophilic Esophagitis. Results: A total of 465 children (M 42% mean age 7.1 years (range: 1–16)) were diagnosed with celiac disease. Three hundred and seventy patients underwent endoscopy, and esophageal biopsies were available in 313. The prevalence of esophageal eosinophilia in children with celiac disease was 1.6% (95% CI: 0.54–2.9%). Only one child was diagnosed as eosinophilic esophagitis; we calculated a prevalence of 0.3% (95% CI: 0.2–0.5%). The odds ratio for an association between eosinophilic esophagitis and celiac disease was at least 6.5 times higher (95% CI: 0.89–47.7%; <i>p</i> = 0.06) than in the general population. Conclusion: The finding of an increased number of eosinophils (>15/HPF) in celiac patients does not have a clinical implication or warrant intervention, and therefore we do not recommend routine esophageal biopsies unless clinically indicated.https://www.mdpi.com/2072-6643/13/11/3755celiac diseaseesophageal eosinophiliaeosinophilic esophagitiseosinophilic gastrointestinal disorders |
| spellingShingle | Fernanda Cristofori Fulvio Salvatore D’Abramo Vincenzo Rutigliano Vanessa Nadia Dargenio Stefania Castellaneta Domenico Piscitelli Davide De Benedittis Flavia Indrio Lidia Celeste Raguseo Michele Barone Ruggiero Francavilla Esophageal Eosinophilia and Eosinophilic Esophagitis in Celiac Children: A Ten Year Prospective Observational Study Nutrients celiac disease esophageal eosinophilia eosinophilic esophagitis eosinophilic gastrointestinal disorders |
| title | Esophageal Eosinophilia and Eosinophilic Esophagitis in Celiac Children: A Ten Year Prospective Observational Study |
| title_full | Esophageal Eosinophilia and Eosinophilic Esophagitis in Celiac Children: A Ten Year Prospective Observational Study |
| title_fullStr | Esophageal Eosinophilia and Eosinophilic Esophagitis in Celiac Children: A Ten Year Prospective Observational Study |
| title_full_unstemmed | Esophageal Eosinophilia and Eosinophilic Esophagitis in Celiac Children: A Ten Year Prospective Observational Study |
| title_short | Esophageal Eosinophilia and Eosinophilic Esophagitis in Celiac Children: A Ten Year Prospective Observational Study |
| title_sort | esophageal eosinophilia and eosinophilic esophagitis in celiac children a ten year prospective observational study |
| topic | celiac disease esophageal eosinophilia eosinophilic esophagitis eosinophilic gastrointestinal disorders |
| url | https://www.mdpi.com/2072-6643/13/11/3755 |
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