- D3.538 - Aeroallergen sensitisation as a risk factor for paediatric eosinophilic esophagitis

Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal disease frequently associated withatopic conditions. However, the extent and nature of this association remain unclear in children. The objectives of this study were, first, to determine the prevalence of atopic conditions in a paediatric population with known EoE; and, second, to screen children with aeroallergen sensitisation for EoE symptoms in order to estimate the prevalence of EoE in this at-risk population.

We retrospectively described atopic profiles of paediatric patients previously diagnosed with EoE. We prospectively recruited children with confirmed aeroallergen sensitisation, who completed a screening questionnaire targeting symptoms suggestive of EoE. Patients with positive screening results were referred to a paediatric gastroenterologist for further evaluation, including esophagogastroduodenoscopy with biopsy when indicated, to confirm or exclude EoE.

In the retrospective cohort of 83 patients (median age: 9.4 years), 69.9% were sensitised to aeroallergens, 61.4% had asthma, 57.8% had allergic rhinitis (AR), 41.0% had atopic dermatitis and 43.4% had IgE-mediated food allergies. Neither the severity of these conditions nor the number of concurrent atopic diseases correlated with peak eosinophil counts on esophageal biopsies. In the prospective cohort, 168 aeroallergen-sensitised children (median age: 9.6 years) were enrolled. Of these, 56 (33.3%) had positive screening questionnaires and 3 were subsequently diagnosed with EoE. Notably, AR—regardless of its severity—was associated with an increased risk of EoE-related symptoms.

A high prevalence of aeroallergen sensitisation was observed among children with EoE. We recommend routine screening of patients with respiratory sensitisation—especially those with AR—using a brief questionnaire, followed by a paediatric gastroenterologist consultation for EoE evaluation.