Eosinophilic esophagitis prevalence may be higher than thought in pediatric patients with asthma

Screening for eosinophilic esophagitis (EoE) in a pediatric asthma clinic may identify more patients than previously thought, according to a study published online June 23 in The Journal of Allergy and Clinical Immunology: In Practice.

Robert E. Becker, M.D., of the Medical College of Wisconsin in Milwaukee, and colleagues estimated the prevalence of EoE among pediatric patients with asthma using noninvasive screening. The analysis included responses to a modified Pediatric Eosinophilic Esophagitis Symptom Severity v2.0 survey administered to 189 patients with asthma (ages 7 to 17) or parents of patients with asthma (ages 3 to 6) seen at a tertiary care center’s asthma and allergy clinic.

The researchers found that 80.4% screened positive, and 47.4% of those patients were referred to gastroenterology. Of those referred, 61.1% completed the referral. Among the 24 who underwent endoscopy, one-third were diagnosed with EoE. Among patients with asthma in the asthma and allergy clinic population, the total projected prevalence of EoE was 8.0%, rising to 13.9% when accounting for nonparticipants and those lost to follow-up. The only individual screening symptom significantly associated with an EoE diagnosis was vomiting.

“Screening in a pediatric asthma clinic identified a previously unrecognized high prevalence of EoE,” the authors write. “This approach may facilitate earlier diagnosis, prevent fibrostenotic complications and reduce racial disparities.”

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