Differences between childhood- and adulthood-onset eosinophilic esophagitis: An analysis from the EoE connect registry.
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Laserna-Mendieta Emilio José, Navarro Pilar, Casabona-Francés Sergio, Savarino Edoardo V, Pérez-Martínez Isabel, Guagnozzi Danila, Barrio Jesús, Perello Antonia, Guardiola-Arévalo Antonio, Betoré-Glaria María Elena, Blas-Jhon Leonardo, Racca Francesca, Krarup Anne Lund, Gutiérrez-Junquera Carolina, Fernández-Fernández Sonia, la Riva Susana De, Naves Juan E, Carrión Silvia, García-Morales Natalia, Roales Valentín, Rodríguez-Oballe Juan Armando, Dainese Raffaella, Rodríguez-Sánchez Alba, Masiques-Mas María Lluisa, Feo-Ortega Sara, Ghisa Matteo, Maniero Daria, Suarez Adolfo, Llerena-Castro Ronald, Gil-Simón Paula, de la Peña-Negro Luisa, Granja-Navacerrada Alicia, Alcedo Javier, Hurtado de Mendoza-Guena Lonore, Pellegatta Gaia, Pérez-Fernández María Teresa, Santander Cecilio, Tamarit-Sebastián Sonsoles, Arias Ángel, Lucendo Alfredo J, EUREOS EoE CONNECT Research group
Аннотация
AIM: To compare disease characteristics, endoscopic and histological features, allergic concomitances and therapeutic choices across ages.
METHODS: Cross-sectional analysis of the EoE CONNECT registry.
RESULTS: The adulthood-onset cohort (those diagnosed at ≥18y) comprised 1044 patients and the childhood-onset cohort (patients diagnosed at <18 y), 254. Vomiting, nausea, chest and abdominal pain, weight loss, slow eating and food aversion were significantly more frequent in children; dysphagia, food bolus impaction and heartburn predominated in adults. A family history of EoE was present in 16% of pediatric and 8.2% of adult patients (p<0.001). Concomitant atopic diseases did not vary across ages. Median±IQR diagnostic delay (years) from symptom onset was higher in adults (2.7 ± 6.1) than in children (1 ± 2.1; p<0.001). Esophageal strictures and rings predominated in adults (p<0.001), who underwent esophageal dilation more commonly (p = 0.011). Inflammatory EoE phenotypes were more common in children (p = 0.001), who also presented higher eosinophil counts in biopsies (p = 0.015) and EREFS scores (p = 0.017). Despite PPI predominating as initial therapy in all cohorts, dietary therapy and swallowed topical corticosteroids were more frequently prescribed in children (p<0.001).
CONCLUSIONS: Childhood-onset EoE has differential characteristics compared with adulthood-onset, but similar response to treatment.