AUTHOR=Nader Luiza Salgado , Epifanio Matias , Coelho Mariana Guimarães , Steinhaus Cintia , Melere Melina , da Silva Carolina Soares , Ferreira Cristina Targa 

TITLE=High prevalence of response to PPI treatment in children and adolescents with eosinophilic esophagitis in southern Brazil

JOURNAL=Frontiers in Allergy

VOLUME=Volume 5 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/allergy/articles/10.3389/falgy.2024.1346843

DOI=10.3389/falgy.2024.1346843

ISSN=2673-6101

ABSTRACT=Introduction: Eosinophilic esophagitis is a newly recognized entity, in which there is significant evidence available that clearly demonstrates the positive impact of PPIs on reducing esophageal eosinophilia. In Brazil, there seems to be a lack of studies that have prospectively assessed the clinical and therapeutic response rate in pediatric patients with EoE. The objective of this study was to prospectively evaluate the clinical and therapeutic response of pediatric patients with EoE in a medical center located in southern Brazil, by investigating the effectiveness of PPI treatment.This study is a clinical, prospective, open trial that took place in a pediatric hospital located in southern Brazil. The focus of the study was on patients diagnosed with Eosinophilic Esophagitis (EoE) who were given treatment using omeprazole/esomeprazole at a dosage of 1mg.kg per dose, twice daily, for a period of 8-12 weeks. Following the treatment period, the patients underwent another endoscopy.Patients who exhibited 15 or less eosinophils in the biopsy conducted after the treatment were considered as responders.Results: A total of 27 patients was evaluated (74,1% boys). The average age (+-standard deviation) was 8 years (+-4). Nineteen patients (70,3%) were considered as responders to PPI treatment: 6 patients -22,2% -exhibited a complete response (defined as having 5 or fewer eosinophil per high power field. Additionally, 13 patients -48,1%demonstrated a partial response, characterized by eosinophil counts exceeding 5 but less than 15 eos/hpf. When comparing the responder and non-responder groups at presentation, a statistical difference was observed in the prevalence of food refusal as a presenting symptom. Food refusal was found to be more prevalent in the non-responder group (87,5% versus 26,3%, P=0.008). No differences were observed in terms of atopy history and endoscopic scores. Upon comparing the histological findings from the posttreatment endoscopy of the two groups, it was observed that PPI responders exhibited a greater tendency to decrease basal cell hyperplasia (P=0,06) and intercellular edema (P=0.08).In this group of pediatric patients with EoE in Southern Brazil most patients showed a high prevalence of histological, endoscopic, and clinical response to PPI treatment. PPIs showed efficacy in Brazilian patients with EoE.