Comorbid Conditions of Eosinophilic Esophagitis

Children with EoE are at risk for allergic and nonallergic comorbidities. 

Allergic Comorbidities

Most children with Eosinophilic Esophagitis (EoE) have other allergic conditions, likely resulting from a shared pathophysiology. Allergic comorbidities based on several pediatric studies show the following prevalence ranges:

• Allergic rhinitis: 57% to 60%
• Asthma: 45% to 60%
• Atopic dermatitis: 18% to 46%
• IgE-mediated food allergy: 30% to 68%

In a large, multicenter study of 705 patients (0.9–57.0 years of age), 91% of participants with EoE had a concomitant allergic condition.

• The interplay between comorbid allergic conditions and EoE is complex and can include worsening EoE symptoms from exposure to food or aeroallergens or when other conditions have increased symptoms.
• Children with poorly controlled asthma, allergic rhinitis and atopic dermatitis can experience poor sleep quality, increased stress, and decreased quality of life, all of which can worsen symptoms of EoE or affect the perception of symptoms.

Nonallergic Comorbidities

Notable comorbidities that are not related to allergic conditions include:

• Failure to thrive (21%)
• Neurodevelopmental disorders – children with autism spectrum disorder have higher rates of EoE than the general population; one study showed that the prevalence of a neurodevelopmental disorder in patients with EoE is 30%.
• Gastroesophageal reflux disease (GERD) – 54%
• Celiac disease – 2% (1% in the general population)
• Autoimmune disease – 4.7% (3.2% in the general population)
• Depression – 9.3% in children with EoE younger than 11 years (<2% in the general population) to 19% in those 11 to 17 years of age (compared to 6% in the general population).

The risk for EoE is increased, and tends to be comparatively severe, in children who have undergone repair of esophageal atresia.

• Monitoring for EoE in children with repaired esophageal atresia can prevent the onset of severe EoE disease.

The development of this information was made possible through support from Sanofi Genzyme and Regeneron.