Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Oct 24;13(11):3755.
doi: 10.3390/nu13113755.

Esophageal Eosinophilia and Eosinophilic Esophagitis in Celiac Children: A Ten Year Prospective Observational Study

Fernanda Cristofori  1 , Fulvio Salvatore D'Abramo  2 , Vincenzo Rutigliano  1 , Vanessa Nadia Dargenio  1 , Stefania Castellaneta  1 , Domenico Piscitelli  3 , Davide De Benedittis  4 , Flavia Indrio  5 , Lidia Celeste Raguseo  1 , Michele Barone  2 , Ruggiero Francavilla  1
Affiliations
Observational Study

Esophageal Eosinophilia and Eosinophilic Esophagitis in Celiac Children: A Ten Year Prospective Observational Study

Fernanda Cristofori et al. Nutrients. .

Abstract

The association between eosinophilic esophagitis and celiac disease is still controversial and its prevalence is highly variable. We aimed to investigate the prevalence of esophageal eosinophilia and eosinophilic esophagitis in a large group of children with celiac disease, prospectively followed over 11 years.

Methods: Prospective observational study performed between 2008 and 2019. Celiac disease diagnosis was based on ESPGHAN criteria. At least four esophageal biopsies were sampled in patients who underwent endoscopy. The presence of at least 15 eosinophils/HPF on esophageal biopsies was considered suggestive of esophageal eosinophilia; at the same time, eosinophilic esophagitis was diagnosed according to the International Consensus Diagnostic Criteria for Eosinophilic Esophagitis.

Results: A total of 465 children (M 42% mean age 7.1 years (range: 1-16)) were diagnosed with celiac disease. Three hundred and seventy patients underwent endoscopy, and esophageal biopsies were available in 313. The prevalence of esophageal eosinophilia in children with celiac disease was 1.6% (95% CI: 0.54-2.9%). Only one child was diagnosed as eosinophilic esophagitis; we calculated a prevalence of 0.3% (95% CI: 0.2-0.5%). The odds ratio for an association between eosinophilic esophagitis and celiac disease was at least 6.5 times higher (95% CI: 0.89-47.7%; p = 0.06) than in the general population.

Conclusion: The finding of an increased number of eosinophils (>15/HPF) in celiac patients does not have a clinical implication or warrant intervention, and therefore we do not recommend routine esophageal biopsies unless clinically indicated.

Keywords: celiac disease; eosinophilic esophagitis; eosinophilic gastrointestinal disorders; esophageal eosinophilia.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of participants. CD: Celiac disease; EoE: Eosinophilic esophagitis; EsEo: Esophageal eosinophilia; ESPGHAN: European Society of Gastroenterology, Hepatology and Nutrition; GFD: gluten-free diet.
See this image and copyright information in PMC

References

    1. Husby S., Koletzko S., Korponay-Szabó I., Kurppa K., Mearin M.L., Ribes-Koninckx C., Shamir R., Troncone R., Auricchio R., Castillejo G., et al. European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020. J. Pediatric Gastroenterol. Nutr. 2020;70:141–156. - PubMed
    1. Dellon E.S., Liacouras C.A., Molina-Infante J., Furuta G.T., Spergel J.M., Zevit N., Spechler S.J., Attwood S.E., Straumann A., Aceves S.S., et al. Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the AGREE Conference. Gastroenterology. 2018;155:1022–1033.e10. - PMC - PubMed
    1. Ludvigsson J.F., Aro P., Walker M.M., Vieth M., Agréus L., Talley N.J., Murray J.A., Ronkainen J. Celiac disease, eosinophilic esophagitis and gastro-esophageal reflux disease, an adult population-based study. Scand. J. Gastroenterol. 2013;48:808–814. doi: 10.3109/00365521.2013.792389. - DOI - PMC - PubMed
    1. Hommeida S., Alsawas M., Murad M.H., Katzka D.A., Grothe R.M., Absah I. The Association Between Celiac Disease and Eosinophilic Esophagitis: Mayo Experience and Meta-analysis of the Literature. J. Pediatric Gastroenterol. Nutr. 2017;65:58–63. doi: 10.1097/MPG.0000000000001499. - DOI - PubMed
    1. Patton T., Chugh A., Padhye L., DeGeeter C., Guandalini S. Pediatric Celiac Disease and Eosinophilic Esophagitis: Outcome of Dietary Therapy. J. Pediatric Gastroenterol. Nutr. 2019;69:e43–e48. - PubMed

Publication types

MeSH terms