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A130 LONGITUDINAL GROWTH OF PREESCHOOLERS WITH EOSINOPHILIC ESOPHAGITIS
BACKGROUND: Eosinophilic 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 d...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859181/ http://dx.doi.org/10.1093/jcag/gwab049.129 |
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author | Carrión-Jaramillo, E Vurzinger, M Avinashi, V |
author_facet | Carrión-Jaramillo, E Vurzinger, M Avinashi, V |
author_sort | Carrión-Jaramillo, E |
collection | PubMed |
description | BACKGROUND: Eosinophilic 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. AIMS: Assess baseline anthropometric measurements in preescholers with EoE and evaluate their growth parameters in follow up. METHODS: A 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. RESULTS: There 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. CONCLUSIONS: Among 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. FUNDING AGENCIES: None |
format | Online Article Text |
id | pubmed-8859181 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-88591812022-02-22 A130 LONGITUDINAL GROWTH OF PREESCHOOLERS WITH EOSINOPHILIC ESOPHAGITIS Carrión-Jaramillo, E Vurzinger, M Avinashi, V J Can Assoc Gastroenterol Poster of Distinction BACKGROUND: Eosinophilic 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. AIMS: Assess baseline anthropometric measurements in preescholers with EoE and evaluate their growth parameters in follow up. METHODS: A 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. RESULTS: There 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. CONCLUSIONS: Among 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. FUNDING AGENCIES: None Oxford University Press 2022-02-21 /pmc/articles/PMC8859181/ http://dx.doi.org/10.1093/jcag/gwab049.129 Text en ڣ The Author(s) 2022. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Poster of Distinction Carrión-Jaramillo, E Vurzinger, M Avinashi, V A130 LONGITUDINAL GROWTH OF PREESCHOOLERS WITH EOSINOPHILIC ESOPHAGITIS |
title | A130 LONGITUDINAL GROWTH OF PREESCHOOLERS WITH EOSINOPHILIC ESOPHAGITIS |
title_full | A130 LONGITUDINAL GROWTH OF PREESCHOOLERS WITH EOSINOPHILIC ESOPHAGITIS |
title_fullStr | A130 LONGITUDINAL GROWTH OF PREESCHOOLERS WITH EOSINOPHILIC ESOPHAGITIS |
title_full_unstemmed | A130 LONGITUDINAL GROWTH OF PREESCHOOLERS WITH EOSINOPHILIC ESOPHAGITIS |
title_short | A130 LONGITUDINAL GROWTH OF PREESCHOOLERS WITH EOSINOPHILIC ESOPHAGITIS |
title_sort | a130 longitudinal growth of preeschoolers with eosinophilic esophagitis |
topic | Poster of Distinction |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859181/ http://dx.doi.org/10.1093/jcag/gwab049.129 |
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