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Eosinophilic Esophagitis Disease in Children from West Virginia

A Review of the Last Decade (1995–2004)

Gill, Rupa, M.D.1; Durst, Paul, M.D.2; Rewalt, Mary, B.A.1; Elitsur, Yoram, M.D.1

American Journal of Gastroenterology: October 2007 - Volume 102 - Issue 10 - p 2281–2285

BACKGROUND Eosinophilic esophagitis (EoE) is a newly established disease in adults and children. The incidence and prevalence of the disease among children from the United States are largely unknown. We examined the endoscopy reports of children who attended our gastroenterology clinic in the last 10 yr.

MATERIALS A AND METHODS A retrospective review of all diagnostic upper endoscopy procedures was executed between 1995–2004, of which a quarter (25%) per each year was randomly selected for pathological reevaluation of the number of Eos. The diagnosis of EoE was established when higher than 15 Es/hpf was detected in the esophageal biopsy; and the prevalence of EoE was calculated. The clinical symptoms, endoscopic presentation, and treatment of the patients with EoE disease were also reviewed.

RESULTS A total of 1,424 procedures were reviewed, of which 355 esophageal samples were reevaluated. During the study period, 44 patients were diagnosed with EoE. The prevalence rate of EoE disease was 0.73/10,000 children during the study period. Similar results were found when the number of Eos was established at >20 Es/hpf. Abdominal pain (55%), vomiting (43%), and heartburn (39%) were the most common symptoms, and characteristic mucosal appearance was found in only 11% of the patients.

CONCLUSION The rate of EoE in our pediatric patient population is low. Prospective studies are needed to establish the incident and prevalence of EoE disease in children living in the United States.

1Department of Pediatrics, Section of Gastroenterology, and 2Department of Pathology, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia

Reprint requests and correspondence: Yoram Elitsur, M.D., 1600 Medical Center Drive, Suite 3500, Huntington, WV 25701.

CONFLICT OF INTEREST Guarantor of the article: Dr. Elitsur, M.D.

Specific author contributions: Dr. Gill collected the data and participated in the manuscript. Dr. Durst is the pathologist who helped in the histological evaluation of the slides and approved the manuscript, Mrs. Rewalt is the research assistant who helped with collection of the samples, assembling the data, and proofreading the manuscript, and Dr. Elitsur is the owner of the study, and serves as the primarily mentor to the resident (Dr. Gill). He also contributed significantly to the writing and revising of the manuscript.

Financial support: None.

Potential competing interests: None.

Received October 2, 2006; accepted April 15, 2007.

© The American College of Gastroenterology 2007. All Rights Reserved.
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