Children with known skin, respiratory, and food allergies need to be screened for a food sensitivity that causes inflammation in the esophagus, findings of a new study suggest.
Pediatric allergists who analyzed a big group of children said that children with allergies should be screened for eosinophilic esophagitis (EoE). The condition is a chronic allergy/immune condition characterized by painful inflammation of the esophagus.
Component Of Allergic March
David Hill, from Children's Hospital of Philadelphia (CHOP), and colleagues said that EoE may have to be considered a later component of the "allergic march".
Allergic march, also known as atopic march, refers to the typical progression of allergic diseases that often start early in life. It is the natural history through which many kids develop a series of allergies one after another. Children typically progress from a skin allergy, then food allergy, and respiratory allergy.
The study, which was published in the Journal of Allergy and Clinical Immunology: In Practice on Monday, is the first to suggest EoE as a component of allergic march.
"Allergic comorbidities are positively associated with EoE diagnosis," the researchers wrote in their study. "Our findings suggest that EoE is a late manifestation of the allergic march."
Children With Increased Risk Of Developing EoE
Hill said children with more allergies have increased risk of developing EoE. In particular, children with three allergies other than EoE were nine times at higher risk of developing EoE than children with no known allergies.
Children with EoE also tend to have increased risk of developing allergic rhinitis, or seasonal allergy, than those without the condition.
"The connection among these allergies suggests a common underlying biological cause," Hill said.
The researcher added that the findings also suggest that later allergies can be potentially prevented when an earlier type of allergy is treated.
Mortality, Morbidity, And Symptoms Of EoE
EoE has low death rate compared with other anaphylactic food allergies such as sensitivity to peanuts but it has high morbidity. It occurs in about one in 1,500 children and is often genetically related.
EoE is also triggered by certain food but the culprit may not be apparent so patients may have to follow a restricted diet until the offending food is identified. It has slow-onset symptoms, which include pain in swallowing, stomach ache, reflux, and food lodged in the esophagus.
The condition is slow to manifest, and may sometimes get misdiagnosed, or may continue to remain undiagnosed until adolescence.