Comparison of atopic features between children and adults with eosinophilic esophagitis

Abstract

Eosinophilic esophagitis (EoE) is a clinicopathological diagnosis seen in children as well as adults. Growing evidence suggests that EoE is strongly associated with atopic disorders. Presenting symptoms differ in children and adults and it is not known whether atopic features vary by age. This study was designed to compare atopic features and allergic sensitization between children and adults with EoE. We conducted a retrospective analysis of demographic and clinical data from 50 children (aged 2-18 years) and 50 adults (aged 21-75 years) with a biopsy-proven diagnosis of EoE referred to our allergy clinic. Data regarding patient characteristics, history of atopic diseases, and allergy test results were collected for analysis. The majority of children and adults were white and male patients. When compared with adults, a higher percentage of children had a history of asthma (52% versus 24%; p < 0.05). There was no statistically significant difference between adults and children regarding history of allergic rhinitis, atopic dermatitis, immunoglobulin E-mediated food allergy, and family history of atopy. There was no statistically significant difference between children and adults regarding immediate-type sensitization to foods and aeroallergens. Compared with adults, a higher percentage of children showed a positive reaction to one or more foods on patch testing (62% versus 31%; p = 0.01). A high prevalence of comorbid atopic diseases and sensitizations to food and environmental allergens was seen in both children and adults. Children had a significantly higher rate of asthma and positive patch test to foods compared with adults.

Figure 1.

History of atopy in children and adults with eosinophilic esophagitis (EoE). Each bar represents the percentage of participants, all (n = 100), children (n = 46), and adults (n = 45), with a positive history for that particular atopic disease except for the family history group where data for 4 children and 5 adults is missing (*p < 0.05).

Figure 2.

Allergy testing in children and adults with eosinophilic esophagitis (EoE). Each bar represents the percentage of participants with positive testing for that category. Numbers within the bars represent the n of that group (*p < 0.05; NS = p > 0.05).