Τίτλος:
Pediatric Eosinophilic Esophagitis: Results of the European Retrospective Pediatric Eosinophilic Esophagitis Registry (RetroPEER)
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
OBJECTIVES: Recommendations for diagnosing and treating eosinophilic esophagitis (EoE) are evolving; however, information on real world clinical practice is lacking. To assess the practices of pediatric gastroenterologists diagnosing and treating EoE and to identify the triggering allergens in European children. METHODS: Retrospective anonymized data were collected from 26 European pediatric gastroenterology centers in 13 countries. Inclusion criteria were: Patients diagnosis with EoE, completed investigations prescribed by the treating physician, and were on stable medical or dietary interventions. RESULTS: In total, 410 patients diagnosed between December 1999 and June 2016 were analyzed, 76.3% boys. The time from symptoms to diagnosis was 12 ± 33.5 months and age at diagnosis was 8.9 ± 4.75 years. The most frequent indications for endoscopy were: dysphagia (38%), gastroesophageal reflux (31.2%), bolus impaction (24.4%), and failure to thrive (10.5%). Approximately 70.3% had failed proton pump inhibitor treatment. The foods found to be causative of EoE by elimination and rechallenge were milk (42%), egg (21.5%), wheat/gluten (10.9%), and peanut (9.9%). Elimination diets were used exclusively in 154 of 410 (37.5%), topical steroids without elimination diets in 52 of 410 (12.6%), both diet and steroids in 183 of 410 (44.6%), systemic steroids in 22 of 410 (5.3%), and esophageal dilation in 7 of 410 (1.7%). Patient refusal, shortage of endoscopy time, and reluctance to perform multiple endoscopies per patient were noted as factors justifying deviation from guidelines. CONCLUSIONS: In this "real world" pediatric European cohort, milk and egg were the most common allergens triggering EoE. Although high-dose proton pump inhibitor trials have increased, attempted PPI treatment is not universal.
Συγγραφείς:
Hoofien, A.
Dias, J.A.
Malamisura, M.
Rea, F.
Chong, S.
Oudshoorn, J.
Nijenhuis-Hendriks, D.
Otte, S.
Papadopoulou, A.
Romano, C.
Gottrand, F.
Miravet, V.V.
Orel, R.
Oliva, S.
Junquera, C.G.
Załęski, A.
Urbonas, V.
Garcia-Puig, R.
Gomez, M.J.M.
Dominguez-Ortega, G.
Auth, M.K.-H.
Kori, M.
Ben Tov, A.
Kalach, N.
Velde, S.V.
Furman, M.
Miele, E.
Marderfeld, L.
Roma, E.
Zevit, N.
Περιοδικό:
Journal of Pediatric Gastroenterology and Nutrition,
Λέξεις-κλειδιά:
adolescent; child; clinical trial; eosinophilic esophagitis; Europe; female; human; male; multicenter study; preschool child; register; retrospective study, Adolescent; Child; Child, Preschool; Eosinophilic Esophagitis; Europe; Female; Humans; Male; Registries; Retrospective Studies
DOI:
10.1097/MPG.0000000000002215
