Abstract
Background
Direct comparisons of childhood- and adulthood-onset eosinophilic esophagitis (EoE)
are scarce.
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.
Keywords
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Article info
Publication history
Published online: October 21, 2022
Accepted:
September 30,
2022
Received:
February 20,
2022
Identification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
