Faculty Collaboration Database

Pediatric Celiac Disease and Eosinophilic Esophagitis: Outcome of Dietary Therapy. J Pediatr Gastroenterol Nutr 2019 Aug;69(2):e43-e48

Date

03/29/2019

Pubmed ID

30921260

DOI

10.1097/MPG.0000000000002343

Scopus ID

2-s2.0-85087436787 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

OBJECTIVE: The coexistence of celiac disease (CeD) and eosinophilic esophagitis (EoE) in pediatric patients has been increasingly recognized. In the current study, we have aimed to assess the outcomes of therapeutic dietary interventions in a cohort of pediatric patients with CeD and EoE.

METHODS: Pediatric patient records obtained from the University of Chicago Celiac Center Database from August 2008 to July 2013 were reviewed. Information was collected on patients with concomitant CeD and EoE regarding age, sex, dates of diagnoses, presenting symptoms, length of symptoms before diagnosis, familial and personal atopic history, dietary therapy, and esophageal histologic response to dietary therapy.

RESULTS: A total of 350 records of patients with CeD were reviewed. Twenty-two (6.3%) had a confirmed diagnosis of CeD and EoE, 17 had repeat biopsies. Four of 17 (23.5%) had resolution of esophageal eosinophilia on an exclusive gluten-free diet, 10 of 17 (59%) required additional eliminations to show histologic resolution, 1 of 17 (6%) had not reached histological remission, and 2 of 17 (12%) were lost to follow-up. Success rates of single food reintroductions were: soy 5 of 5 (100%), eggs 3 of 5 (60%), dairy 3 of 7 (43%), nuts 2 of 4 (50%), and fish 2 of 4 (50%).

CONCLUSIONS: To our knowledge, this is the largest pediatric study to assess the histologic outcome of EoE-associated esophageal eosinophilia in response to dietary management of pediatric patients with concomitant CeD and EoE. We demonstrate that soy is well tolerated in this cohort, and suggest that reintroducing this food first, or trialing a soy-inclusive elimination diet is a viable strategy.

Author List

Patton T, Chugh A, Padhye L, DeGeeter C, Guandalini S

Author

Ankur A. Chugh MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Celiac Disease
Child
Child, Preschool
Cohort Studies
Databases, Factual
Diet, Gluten-Free
Eosinophilic Esophagitis
Female
Humans
Infant
Infant, Newborn
Male
Retrospective Studies
Treatment Outcome