Eosinophilic esophagitis disease in children from West Virginia: a review of the last decade (1995-2004)

BACKGROUND: Eosinophilic esophagitis (EoE) is a newly established disease in adults and children. The incidence and prevalence of the disease among children from the United States are largely unknown. We examined the endoscopy reports of children who attended our gastroenterology clinic in the last 10 yr. MATERIALS A AND METHODS: retrospective review of all diagnostic upper endoscopy procedures was executed between 1995-2004, of which a quarter (25%) per each year was randomly selected for pathological reevaluation of the number of Eos. The diagnosis of EoE was established when higher than 15 Es/hpf was detected in the esophageal biopsy; and the prevalence of EoE was calculated. The clinical symptoms, endoscopic presentation, and treatment of the patients with EoE disease were also reviewed. RESULTS: A total of 1,424 procedures were reviewed, of which 355 esophageal samples were reevaluated. During the study period, 44 patients were diagnosed with EoE. The prevalence rate of EoE disease was 0.73/10,000 children during the study period. Similar results were found when the number of Eos was established at >20 Es/hpf. Abdominal pain (55%), vomiting (43%), and heartburn (39%) were the most common symptoms, and characteristic mucosal appearance was found in only 11% of the patients. CONCLUSION: The rate of EoE in our pediatric patient population is low. Prospective studies are needed to establish the incident and prevalence of EoE disease in children living in the United States.