Otorhinolaryngological Manifestations of Eosinophilic Esophagitis in Children: a Case Control Study

Margarida Lagarto Bento, Joana Ximenes Araújo, Mariana Lobato, Ana Castro Neves, Paula Leiria Pinto, José Cabral, Ezequiel Barros


Introduction: Eosinophilic esophagitis (EoE) is strongly associated with atopy and studies suggest that 47 to 84% of children with EoE have allergic rhinitis. Otorhinolaryngological conditions such as airway symptoms, recurrent otitis media and chronic sinonasal disease also seem to be more frequent in these patients. To our best knowledge, there are no studies showing if the frequency of these symptoms is superior in children with EoE.

Objectives: The aim of this study is to determine whether otorhinolaryngological manifestations are more prevalent in children with EoE.

Methods: Case control study adjusted for gender, age and control of rhinitis symptoms. The study group included children diagnosed with EoE and the control group consisted of children with allergic rhinitis. All children were evaluated under an otorhinolaryngological observation protocol and the CARAT kids questionnaire was used 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.

Palabras clave

Eosinophilic esophagitis; Otorhinolaryngology; allergic rhinitis; children

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