EoE ToT Module 4 References-Hill et al J Allergy Clin Immunol Pract 2018 EoE is a late manifestation of the allergic march

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

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Eosinophilic Esophagitis (EoE) is identified as a late manifestation in the progression of allergic diseases known as the "allergic march." This condition is a chronic inflammatory disease of the esophagus typically triggered by specific foods. The study used a cohort of 130,435 children to explore the epidemiologic relationship between EoE and other conditions in the allergic march, including atopic dermatitis (AD), IgE-mediated food allergy (IgE-FA), asthma, and allergic rhinitis (AR).<br /><br />Findings revealed that EoE had a peak diagnosis age of 2.6 years, which is later than AD (0.3 years), IgE-FA (1 year), and asthma (1.1 years), but similar to AR (2.1 years). There was a strong, independent association between the presence of AD, IgE-FA, and asthma with a later diagnosis of EoE. Specifically, the hazard ratios (HR) were 3.2 for AD, 9.1 for IgE-FA, and 1.9 for asthma. Moreover, the risk of developing EoE increased cumulatively with additional allergic conditions. EoE presence also correlated with a higher incidence of subsequent AR diagnosis (HR 2.5). <br /><br />The study concluded that EoE fits the epidemiologic criteria of the allergic march, sharing genetic and pathophysiologic features with other allergic conditions. Recognizing EoE as part of the allergic march may improve diagnostics and patient management, suggesting a need for proactive screening for EoE in children with existing allergic conditions. This understanding supports a broader approach to managing allergic diseases, acknowledging EoE's place in the allergic spectrum.

Keywords

Eosinophilic Esophagitis

allergic march

chronic inflammatory disease

epidemiologic relationship

atopic dermatitis

IgE-mediated food allergy

asthma

allergic rhinitis

hazard ratios

proactive screening