Allergies linked to increased risk for eosinophilic esophagitis
Patients who have other allergic diseases are more likely to develop eosinophilic esophagitis, according to research presented at the 2018 American Academy of Allergy, Asthma & Immunology and World Allergy Organization Joint Congress.
Jonathan M. Spergel, MD, PhD, FAAAAI, Children’s Hospital of Philadelphia, and colleagues found that the development of eosinophilic esophagitis (EoE) can be a late step on the progression of atopic march, the theory that patients with allergic diseases are more likely to develop another or multiple allergic diseases later in life.
“The cumulative risk of EoE also went up with each subsequent atopic, or allergic, disease,” Spergel said in a press release. “Our findings indicate that EoE falls into the pattern of atopic march, although EoE tends to be diagnosed later in the progression.”
Spergel and colleagues conducted a case-control analysis using a primary care birth cohort of 130,457 children to determine if the presence of atopic dermatitis (AD), IgE-mediated food allergy (FA), asthma or allergic rhinitis (AR) modify the risk for developing EoE. Researchers enrolled the participants into the study before the age 1 year, with follow-ups conducted after 24 months.
Overall, 139 patients developed EoE during the observation period (0.11%), and the peak age for diagnosis was 2.7 years. Peak age for diagnosis was 0.4 years for AD, 1 year for FA, 1.1 years for asthma and 4.1 years for AR, according to the study.
The investigators determined that AD (HR = 2.7; 95% CI, 1.9–4), FA (HR = 8.9; 95% ci, 6.3–12.4) and asthma (HR = 2.2; 95% CI, 1.6–3.1) all independently increased the risk for EoE.
The presence of EoE increased the risk for the future development of AR (HR = 3.8; 95% CI, 1.4–2.7).
The cumulative effect of atopic conditions on the risk for developing EoE was also significant, according to the study. The risk increased with each subsequent atopic diagnosis (one condition, HR = 3.9; 95% CI; 2.6–5.7; two conditions, HR = 6.5; 95% CI; 4.3–9.9; three conditions, HR = 9.8; 95% CI; 5.8–16.8; four conditions, HR = 12.2; 95% CI; 5–30; P .001).
The researchers noted that their findings fit into the normal progression of atopic march, which normally begins in infancy with eczema and can develop into food allergies or hay fever later in life.
“Infants with eczema are more likely to be diagnosed with food allergy or asthma when they are about a year old,” Spergel said in the press release. “If a child was diagnosed with all three conditions, they are even more likely to develop EoE than if they only had one or two other conditions.” – by Alex Young
Hill DA, et al. Abstract 274; Presented at: AAAAI/WAO Joint Congress; March 2-5; Orlando, Florida.
Disclosures: The authors reported no relevant financial disclosures.