D3.405 - Clinical Characteristics and Treatment Response of Eosinophilic Esophagitis in Pediatric Patients: A Descriptive Study from a High-Complexity Colombian Institution

Effective management of Eosinophilic esophagitis (EoE) involves individualized pharmacological and non-pharmacological therapies to improve adherence and prevent complications. This study aims to describe the sociodemographic, clinical, paraclinical characteristics, and treatment responses of pediatric EoE patients in a high-complexity hospital in Cali, Colombia.

A cross-sectional descriptive study was conducted from October 2013 to January 2023. Patients diagnosed with EoE and followed by Pediatric Allergy and/or Gastroenterology were included. Exclusion criteria were gastrointestinal malformations, absence of initial upper digestive endoscopy, and absence of allergy studies.

Seventy-five patients were included, with a mean age of 11 years (5.5-14.5); 27 (36%) were female. Twenty-nine (41%) had a history of atopy in parents and 3 (4.2%) in siblings. One (1.4%) patient had a family history of EoE. The most frequent allergic comorbidities were rhinitis in 42 (56%) patients, asthma in 28 (37%) and food allergy in 7 (9.3%).

The mean age of symptom onset was 4 years (2-8). The most prevalent symptoms were refractory reflux in 39 (52%) patients, abdominal pain in 37 (49%) and emesis in 24 (32%). Food allergen sensitization was found in 21 (29%) patients, including 10 (47.6%) sensitized to milk and 10 (47.6%) to egg. Aeroallergen sensitization was present in 19 (26%) patients, primarily to dust mites in 17 (89%) patients.

Initial treatment was proton pump inhibitors (PPIs) in 47 (62.7%) patients, PPIs with a 1-food elimination diet in 6 (8%), PPIs with swallowed corticosteroids in 5 (6.7%), and corticosteroid monotherapy in 1 (1.3%) patient. Among 37 PPI-treated patients with follow-up endoscopies, 17 (45.9%) achieved clinical and 13 (35.1%) histological remission. All 5 (100%) patients on PPIs plus diet who had follow-up achieved clinical remission, 1 (20%) histological. Of the 3 patients on PPIs plus corticosteroids, 2 (66.7%) achieved both remissions. The single patient on corticosteroid monotherapy (100%) achieved both clinical and histologic remission.

A moderate response rate to PPIs was observed compared to that described in literature. Although multiple treatment options are available, adherence failure and loss to follow-up remain significant limitations for clinical and histological resolution. Future research will aim to better characterize the presentation of EoE in different populations.