EoE ToT Module 2 References-Hill et al J Allergy Clin Immunol Pract 2018 Eosinophilic esophagitis is a late manifestation of the allergic march

Hill et al J Allergy Clin Immunol Pract 2018 Eosinophilic esophagitis is a late manifestation of the allergic march

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The study investigates the epidemiological relationship between eosinophilic esophagitis (EoE) and traditional members of the allergic march, such as atopic dermatitis (AD), IgE-mediated food allergy (IgE-FA), asthma, and allergic rhinitis (AR). The allergic march describes the progression of allergic diseases typically seen in children. Utilizing a birth cohort of 130,435 children, the research explores individuals' natural histories of these allergic conditions and their possible links to EoE.<br /><br />Key findings reveal that the peak age for EoE diagnosis is 2.6 years, which occurs after the peak incidences of AD (0.3 years), IgE-FA (1 year), and asthma (1.1 years), but aligns closely with AR (2.1 years). Additionally, individuals with preceding allergic conditions such as AD, IgE-FA, or asthma have higher rates of subsequent EoE diagnosis, supporting the notion that EoE could be a late manifestation of the allergic march. Specifically, the study found hazard ratios indicating strong associations: AD (HR 3.2), IgE-FA (HR 9.1), and asthma (HR 1.9) significantly increase the risk of developing EoE. Moreover, AR showed a bidirectional relationship with EoE: AR was associated with increased EoE risk (HR 2.8) and vice versa (HR 2.5).<br /><br />This comprehensive epidemiologic assessment supports the hypothesis that EoE is part of the allergic march and underscores the need for active screening for EoE symptoms among children with existing allergic conditions. The study's findings contribute profoundly to the understanding of allergy pathophysiology and patient care by highlighting the interlinked nature of these conditions and how one can predispose to another. Authors recommend considering these associations in clinical practices to better manage and anticipate allergic disease progression in pediatric patients.

Keywords

eosinophilic esophagitis

allergic march

atopic dermatitis

IgE-mediated food allergy

asthma

allergic rhinitis

birth cohort

hazard ratios

epidemiologic assessment

pediatric patients