目的 总结儿童嗜酸细胞性食管炎(EoE)的临床特点。 方法 回顾性分析2017年1月1日至2022年12月31日首都医科大学附属北京儿童医院消化科住院治疗的EoE患儿临床资料。 结果 共纳入EoE患儿18例，其中男13例，女5例，年龄11。96(4。96，12。81)岁。学龄前期患儿呕吐较为常见(4/5例)，学龄期和青春期患儿以腹痛为主(11/13例)。患儿外周血白细胞升高者占22。22%(4/18)，嗜酸性粒细胞升高者占33。33%(6/18)。55。56%(10/18)的患儿或一级亲属存在过敏史，68。75%(11/16)总IgE水平升高，66。67%(12/18)食物变应原阳性，牛奶、鸡蛋和小麦为常见的变应原。内镜下可见食管黏膜充血红斑、粗糙、糜烂、线性溃疡、环状改变、犁沟样或皱纸样改变、颗粒样改变、息肉样改变或贲门口松弛。27。78%(5/18)的患儿内镜下表现正常。病理组织学多表现为食管慢性炎症及嗜酸性粒细胞计数升高。患儿失访3例，其余15例随访时间6个月至2年。患儿均采用饮食回避治疗，9例应用糖皮质激素治疗后较快缓解，其中1例患儿停药后复发，再次激素治疗有效，另有2例消化道症状出现反复或停药后外周血嗜酸性粒细胞升高，回避饮食治疗可缓解。 结论 EoE多见于年长儿，男童多见，学龄前期以呕吐为主要症状，学龄期和青春期多表现为腹痛。部分患儿外周血白细胞和嗜酸性粒细胞升高，多数患儿食物变应原阳性；消化道内镜及病理组织学检查为诊断EoE的重要手段。饮食回避可起到一定治疗作用。糖皮质激素在EoE的治疗中发挥重要作用，但少数患儿存在激素依赖。 Objective To summarize the clinical characteristics of eosinophilic esophagitis (EoE) in children。 Methods Clinical data of children with EoE who were hospitalized in the Department of Gastroenterology， Beijing Children′s Hospital， Capital Medical University from January 1， 2017， to December 31， 2022， were retrospectively analyzed。 Results A total of 18 children with EoE were included in the study， including 13 males and 5 females， with the age of 11。96 (4。96， 12。81) years。Vomiting was more common in preschool children (4/5)， while abdominal pain was the main symptom in school-age and adolescent children (11/13)。 There were 22。22% (4/18) of the children with EoE had an increased white blood cell count， and 33。33%(6/18) had an increased eosinophil count。Allergic history in the first-degree relatives was detected in 55。56%(10/18) of the children with EoE。Total immunoglobulin E (IgE) level was elevated in 68。75% (11/16) of the children。Food-specific IgE was positive in 66。67% (12/18) of the children with EoE。Milk， eggs， and wheat were the most common allergens。Esophageal mucosal hyperemia and erythema， rough， erosion， linear ulcers， annular changes， furrow or wrinkled paper changes， granular changes， polypoid or relaxation of the cardia were seen under endoscopy， whereas 27。78% (5/18) of the children showed normal esophageal mucosa。The histopathology showed chronic inflammation of the esophagus and increased eosinophil count。Three patients were lost of follow-up， and the remaining 15 were followed up for 6-24 months。All children with EoE were treated with the elimination diet。Nine children treated with glucocorticoids experienced clinical remission in a short period of time， involving 1 case with recurrence after withdrawal and being effectively treated by hormone therapy， and 2 cases of repeated digestive system symptoms or increased eosinophil count after withdrawal and being effectively relieved by the elimination diet。 Conclusions EoE is more common in elderly children and boys。Vomiting is the main symptom in pre-school aged children， whereas abdominal pain is the main symptom in school-aged children and adolescents。Increased peripheral white blood cell count and eosinophil count can be detected in some cases， and most of them are positive for food allergen tests。Gastrointestinal endoscopy and histopathology are important in the diagnosis of EoE。Elimination diet may be effective in some patients。Glucocorticoids are of great significance in the treatment of EoE， but a few children are steroid-dependent。
Clinical characteristics of eosinophilic esophagitis in children
Objective To summarize the clinical characteristics of eosinophilic esophagitis (EoE) in children. Methods Clinical data of children with EoE who were hospitalized in the Department of Gastroenterology, Beijing Children′s Hospital, Capital Medical University from January 1, 2017, to December 31, 2022, were retrospectively analyzed. Results A total of 18 children with EoE were included in the study, including 13 males and 5 females, with the age of 11.96 (4.96, 12.81) years.Vomiting was more common in preschool children (4/5), while abdominal pain was the main symptom in school-age and adolescent children (11/13). There were 22.22% (4/18) of the children with EoE had an increased white blood cell count, and 33.33%(6/18) had an increased eosinophil count.Allergic history in the first-degree relatives was detected in 55.56%(10/18) of the children with EoE.Total immunoglobulin E (IgE) level was elevated in 68.75% (11/16) of the children.Food-specific IgE was positive in 66.67% (12/18) of the children with EoE.Milk, eggs, and wheat were the most common allergens.Esophageal mucosal hyperemia and erythema, rough, erosion, linear ulcers, annular changes, furrow or wrinkled paper changes, granular changes, polypoid or relaxation of the cardia were seen under endoscopy, whereas 27.78% (5/18) of the children showed normal esophageal mucosa.The histopathology showed chronic inflammation of the esophagus and increased eosinophil count.Three patients were lost of follow-up, and the remaining 15 were followed up for 6-24 months.All children with EoE were treated with the elimination diet.Nine children treated with glucocorticoids experienced clinical remission in a short period of time, involving 1 case with recurrence after withdrawal and being effectively treated by hormone therapy, and 2 cases of repeated digestive system symptoms or increased eosinophil count after withdrawal and being effectively relieved by the elimination diet. Conclusions EoE is more common in elderly children and boys.Vomiting is the main symptom in pre-school aged children, whereas abdominal pain is the main symptom in school-aged children and adolescents.Increased peripheral white blood cell count and eosinophil count can be detected in some cases, and most of them are positive for food allergen tests.Gastrointestinal endoscopy and histopathology are important in the diagnosis of EoE.Elimination diet may be effective in some patients.Glucocorticoids are of great significance in the treatment of EoE, but a few children are steroid-dependent.
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