A130 LONGITUDINAL GROWTH OF PREESCHOOLERS WITH EOSINOPHILIC ESOPHAGITIS

Abstract

BackgroundEosinophilic esophagitis (EoE) is an immune-mediated condition involving eosinophils infiltrating the esophagus. While adults predominantly present with dysphagia, infants and preschoolers can present with vomiting, poor solid food progression, and oral aversion. Growth is a concern at diagnosis as well as in follow-up based on poor intake, prescribed food elimination, and the potential impact of swallowed steroids.AimsAssess baseline anthropometric measurements in preescholers with EoE and evaluate their growth parameters in follow up.MethodsA retrospective chart review of patients with EoE at BC Children’s Hospital from 2007–21. Inclusion criteria were patients diagnosed before 5 years, with > 2 anthropometrics measurements. Variables included weight, height, BMI, and Z-scores (CDC >2 years; WHO <2 years). The change in Z-scores were calculated between the first registered clinical visit after diagnosis and the most recent growth parameters available. Statistical difference between Z-scores for height and BMI was determined with a paired t-test. Differences in growth according to treatment used one way t-test.ResultsThere were 44 patients included. Mean age of diagnosis was 3 years, 82% were male. The average follow up time was 4.9 years (0.5–12.2 years). At baseline, 1 patient was severely malnourished (Z<-3) and 1 was moderately malnourished based on BMI (Z<-2). At follow-up there were 2 patients with moderate malnutrition. The change in BMI Z-scores over time was relatively neutral -0.05±1.3SD but there were 3 patients with a decline in Z-score more than 2, a different way to represent malnutrition.Stunting was more common at baseline with 3 patients having severe stunting (Z<-3), and 5 having moderate stunting (Z<-2). At follow-up 1 patient had severe stunting BMI (Z<-3), and 1 had moderate stunting (Z<-2). The change in height Z-scores was net +0.41±1.21SD.Last reported treatments included 45.5% on steroids, 18.2% on elimination diet, 11.4% on steroid/diet, 4.5% on PPI, 4.5% on PPI/diet and 15.9% no treatment. There were no significant differences in BMI Z-scores or height Z-scores according to treatment.ConclusionsAmong those diagnosed with EoE at less than 5 years of age, BMI was stable from diagnosis through follow up and reflected the general population. Stunting was observed in as many as 1/5 of patients at diagnosis but did show improvement in follow up. Further analysis would benefit from a larger sample, further treatment details and correlation with esophageal inflammation.BaselineLas reportedp valueMean age (years)3.3± 1.68.7± 2.9BMI%50.4± 34.550.1± 32.4BMI Z score (SD)+0.06± 1.53+0.02± 1.200.8%Malnutrition Z<-2 BMI4.54.5Height% for age34.841.4%Stunting Z<-218.24.50.03*Funding AgenciesNone