Otorhinolaryngological manifestations of Eosinophilic Esophagitis in
children: a case control study
Abstract
Objectives: Otorhinolaryngological conditions seem to be more frequent
in children with Eosinophilic Esophagitis (EoE), including allergic
rhinitis, but, to our best knowledge, there are no studies showing if
the frequency of these conditions is superior in children with EoE. The
aim of this study is to determine whether otorhinolaryngological
manifestations are more prevalent in these children. Design: Case
control study Setting: Tertiary referral Paediatric Hospital of Lisbon,
Portugal. Participants: Children with EoE (cases) and children diagnosed
with allergic rhinitis but not diagnosed with EoE or other eosinophilic
disorders (controls). Main outcome measures: Complete
otorhinolaryngological evaluation of children under an observation
protocol with questions about ear, nose and throat symptoms, and
previous medical history; physical examination and the CARAT kids
questionnaire to evaluate the level of control of children’s rhinitis.
Results: This study included 45 children. The study group consisted of
15 children diagnosed with EoE and the control group consisted of 30
cases with allergic rhinitis. Both groups included 6 to 17 years old
children. There were no differences concerning gender, age, total CARAT
kids score or CARAT kids score for questions for upper and lower
respiratory tract (p>0.05). When otorhinolaryngological
symptoms were analysed separately there were no statistically
significant differences between case and control groups
(p>0.05), except for dysphagia (p=0,036) which was more
prevalent in the case group. There were no significant differences
related to the number of symptoms reported, frequency of asthma,
otorhinolaryngological surgeries in the past, drug allergies, and
documented hearing loss (p>0.05). There were no significant
differences in laryngopharyngeal changes seen as markers for
laryngopharyngeal reflux between both groups (p>0.05).
Conclusions: Apparently, otorhinolaryngological conditions are not more
prevalent in children diagnosed with EoE, but future larger studies are
needed to confirm our findings. Yet, Otorhinolaryngologists must be
aware of this condition since early referral of children with symptoms
related to EoE such as dysphagia and atopy to a Gastroenterology
appointment can speed up diagnosis and treatment, potentially reducing
long-term sequelae.