Prevalence of food allergy and other atopy among children with eosinophilic esophagitis in single centre retrospective study, Riyadh, Saudi Arabia

Abstract

Background: Eosinophilic Esophagitis (EoE) is increasingly recognized as a significant public health issue in pediatric populations. The multifaceted mechanisms involving genetic, environmental, and immunological factors, particularly the role of allergens, are central to understanding EoE's pathogenesis. This study aims to analyze the prevalence of food allergies and atopic diseases among children diagnosed with EoE, offering insights into their interrelations and informing improved management strategies. Methods: This retrospective study analyzed 47 pediatric patients diagnosed with EoE at the Allergy and Gastroenterology Clinic, Children's Hospital, King Saud Medical City, Riyadh, from February 2012 to December 2018. Patients were selected based on documented food allergies, anaphylactic reactions, comorbid atopic conditions, positive RAST results, and elevated eosinophilia. Data collection involved medical records and detailed family questionnaires. Immunological assays and endoscopic biopsies were used for diagnosis, with EoE defined as more than 15 eosinophils/HPF. Results: The study population predominantly comprised Saudi males, with a mean age of 8.36 years. A significant portion had consanguineous parents. Notable findings include a high prevalence of asthma (46.8%), allergic rhinitis (23.4%), and eczema (25.5%). The most common food allergens identified were peanuts, nuts, and seafood. Asthma severity varied, with Ventolin and Fluticasone being the most prescribed medications. Laboratory investigations showed elevated WBC, ANC, Lymph, ESO, eosinophil percentage, and IgE levels. RAST indicated specific allergen sensitivities in 34.0% of patients. Conclusion: This study provides essential insights into the demographic, clinical, and therapeutic aspects of pediatric EoE, emphasizing the importance of a comprehensive, personalized approach to management.