TOPLINE

Symptom-based screening identified a previously unrecognized high prevalence of eosinophilic esophagitis (EoE) in children with asthma evaluated in pediatric asthma and allergy clinics, a prevalence higher than that in the general pediatric population.

METHODOLOGY

• Researchers enrolled 189 children aged 3-17 years with asthma (median age, 8.6 years; 41.3% girls) who were evaluated at a tertiary care asthma and allergy clinic between December 2023 and October 2024 to estimate the prevalence of EoE.
• All children aged 7-17 years or parents of those aged 3-6 years responded to a modified 12-symptom screening survey, adapted from a previously validated surveillance questionnaire.
• Patients who answered “sometimes,” “often,” or “almost always” to any survey items were considered screen-positive and could be referred by the treating allergist to gastroenterology for further evaluation.
• For patients referred to gastroenterology, the decision to perform endoscopy was based on clinical judgment.

TAKEAWAY

• Of the total enrolled children, 80.4% screened positive for symptoms suggestive of EoE. Of them, 47.4% were referred to gastroenterology, and 61.1% completed the referral. Among those who underwent endoscopy, 33.3% were diagnosed with EoE.
• The observed prevalence of EoE was 8.0% (95% CI, 5.1%-11.7%). After accounting for nonparticipants and individuals lost to follow-up, the estimated prevalence increased to 13.9% (95% CI, 10.1%-18.4%).
• Vomiting was the only individual symptom significantly associated with EoE and was reported by 37.5% of children with EoE compared with 1.7% of those without.
• No significant differences in age, sex, race, BMI z-score, or the number of atopic comorbidities were seen between children with and without EoE.

IN PRACTICE

“This noninvasive screening approach revealed a high prevalence of previously undiagnosed EoE and may support earlier diagnosis and prevention of fibrostenotic complications,” the authors of the study wrote.

SOURCE

Robert E. Becker, MD, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, was the corresponding author of the study, which was published online on June 23 in The Journal of Allergy and Clinical Immunology: In Practice.

LIMITATIONS

The prevalence estimates were based on clinician-directed referrals to gastroenterology and recommendations for endoscopy, potentially underestimating the true prevalence of EoE.

DISCLOSURES

The study received no funding, and the authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.