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Rising trend in p​ediatric eosinophilic esophagitis incidence in Spain: Results of a prospective study 2014–16

Objectives The rate of eosinophilic esophagitis (EoE) diagnosis is increasing. This study aims to determine the incidence of EoE in the pediatric population residing in the southwestern Madrid and to analyze whether absolute monthly pollen counts, modified or not by the principal atmospheric polluta...

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Published in:Pediatric allergy and immunology 2021-08, Vol.32 (6), p.1307-1315
Main Authors: La Orden Izquierdo, Enrique, Mahillo‐Fernández, Ignacio, Fernández Fernández, Sonia, Barrio Torres, Josefa, Román Riechmann, Enriqueta, Gutiérrez Junquera, Carolina, Santos, Alexandra, Cilleruelo Pascual, ML, Rayo Fernández, AI, Martínez Escribano, B, Botija Arcos, G, Barrio Merino, A, Urruzuno Tellería, P, Medina Benítez, E, Salcedo Lobato, E, Grande Herrero, L, Miranda Cid, C, Rodrigo García, G, Herrero Álvarez, M, Carabaño Aguado, I, Lancho Monreal, E, Romero Hombrebueno, N
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container_issue 6
container_start_page 1307
container_title Pediatric allergy and immunology
container_volume 32
creator La Orden Izquierdo, Enrique
Mahillo‐Fernández, Ignacio
Fernández Fernández, Sonia
Barrio Torres, Josefa
Román Riechmann, Enriqueta
Gutiérrez Junquera, Carolina
Santos, Alexandra
Cilleruelo Pascual, ML
Rayo Fernández, AI
Martínez Escribano, B
Botija Arcos, G
Barrio Merino, A
Urruzuno Tellería, P
Medina Benítez, E
Salcedo Lobato, E
Grande Herrero, L
Miranda Cid, C
Rodrigo García, G
Herrero Álvarez, M
Carabaño Aguado, I
Lancho Monreal, E
Romero Hombrebueno, N
description Objectives The rate of eosinophilic esophagitis (EoE) diagnosis is increasing. This study aims to determine the incidence of EoE in the pediatric population residing in the southwestern Madrid and to analyze whether absolute monthly pollen counts, modified or not by the principal atmospheric pollutants, are associated with it. Methods A cross‐sectional study on prospectively recruited patients was designed to calculate the incidence of EoE in children aged under 15 years who were diagnosed between September 2014 and August 2016 in twelve hospitals. We collected demographic and symptoms data, date of onset of symptoms, date of medical consultation, and date of endoscopic diagnosis of each included patient. Relative risk estimation was performed to assess the association between the incidence of diagnosis and monthly pollen counts and levels of atmospheric pollutants. All these models were adjusted for the number of total patients that underwent endoscopy at first time. Results One hundred forty‐eight patients were included. The most frequent symptoms were abdominal pain [42.57%], dysphagia [42.57%], and impaction [39%–86%]. The median overall monthly incidence was 1.13 [interquartile rank: 0.97–1.43] cases/100,000 children, and the annual mean was 15.2. The overall analysis of the relationship between incidence and absolute monthly counts, corrected for the number of first‐time endoscopies performed, revealed no statistically significant association with pollen and air pollutants. There was a higher frequency of diagnosis during the pollination period of Cupressaceae [relative risk 1.647; 95% CI (1.192–2.276) p 
doi_str_mv 10.1111/pai.13528
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This study aims to determine the incidence of EoE in the pediatric population residing in the southwestern Madrid and to analyze whether absolute monthly pollen counts, modified or not by the principal atmospheric pollutants, are associated with it. Methods A cross‐sectional study on prospectively recruited patients was designed to calculate the incidence of EoE in children aged under 15 years who were diagnosed between September 2014 and August 2016 in twelve hospitals. We collected demographic and symptoms data, date of onset of symptoms, date of medical consultation, and date of endoscopic diagnosis of each included patient. Relative risk estimation was performed to assess the association between the incidence of diagnosis and monthly pollen counts and levels of atmospheric pollutants. All these models were adjusted for the number of total patients that underwent endoscopy at first time. Results One hundred forty‐eight patients were included. The most frequent symptoms were abdominal pain [42.57%], dysphagia [42.57%], and impaction [39%–86%]. The median overall monthly incidence was 1.13 [interquartile rank: 0.97–1.43] cases/100,000 children, and the annual mean was 15.2. The overall analysis of the relationship between incidence and absolute monthly counts, corrected for the number of first‐time endoscopies performed, revealed no statistically significant association with pollen and air pollutants. There was a higher frequency of diagnosis during the pollination period of Cupressaceae [relative risk 1.647; 95% CI (1.192–2.276) p &lt; .002] and during February and November (relative risk 1.67; p &lt; .01). Conclusions This study confirms the high incidence of eosinophilic esophagitis and also suggests a period of higher incidence of diagnosis in the months of February and November as well as in the period of high pollination of Cupressaceae.</description><identifier>ISSN: 0905-6157</identifier><identifier>EISSN: 1399-3038</identifier><identifier>DOI: 10.1111/pai.13528</identifier><identifier>PMID: 33934414</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Autoimmune diseases ; Children ; Cupressaceae ; Diagnosis ; Dysphagia ; Endoscopy ; eosinophilic esophagitis ; epidemiology ; Esophageal diseases ; Esophagitis ; Esophagus ; Gastrointestinal diseases ; Leukocytes (eosinophilic) ; Patients ; Pediatrics ; Plant reproduction ; Pollen ; Pollination ; Pollutants ; Statistical analysis</subject><ispartof>Pediatric allergy and immunology, 2021-08, Vol.32 (6), p.1307-1315</ispartof><rights>2021 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.</rights><rights>Copyright © 2021 John Wiley &amp; Sons A/S</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-4581cf2bc1d316fe028f86d3903f55e3f113c9c93b557f09d14f6f1381bfd91b3</citedby><cites>FETCH-LOGICAL-c3538-4581cf2bc1d316fe028f86d3903f55e3f113c9c93b557f09d14f6f1381bfd91b3</cites><orcidid>0000-0001-8686-2282</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33934414$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Santos, Alexandra</contributor><creatorcontrib>La Orden Izquierdo, Enrique</creatorcontrib><creatorcontrib>Mahillo‐Fernández, Ignacio</creatorcontrib><creatorcontrib>Fernández Fernández, Sonia</creatorcontrib><creatorcontrib>Barrio Torres, Josefa</creatorcontrib><creatorcontrib>Román Riechmann, Enriqueta</creatorcontrib><creatorcontrib>Gutiérrez Junquera, Carolina</creatorcontrib><creatorcontrib>Santos, Alexandra</creatorcontrib><creatorcontrib>Cilleruelo Pascual, ML</creatorcontrib><creatorcontrib>Rayo Fernández, AI</creatorcontrib><creatorcontrib>Martínez Escribano, B</creatorcontrib><creatorcontrib>Botija Arcos, G</creatorcontrib><creatorcontrib>Barrio Merino, A</creatorcontrib><creatorcontrib>Urruzuno Tellería, P</creatorcontrib><creatorcontrib>Medina Benítez, E</creatorcontrib><creatorcontrib>Salcedo Lobato, E</creatorcontrib><creatorcontrib>Grande Herrero, L</creatorcontrib><creatorcontrib>Miranda Cid, C</creatorcontrib><creatorcontrib>Rodrigo García, G</creatorcontrib><creatorcontrib>Herrero Álvarez, M</creatorcontrib><creatorcontrib>Carabaño Aguado, I</creatorcontrib><creatorcontrib>Lancho Monreal, E</creatorcontrib><creatorcontrib>Romero Hombrebueno, N</creatorcontrib><creatorcontrib>Working group on Eosinophilic esophagitis of the “Gastrosuroeste group” in Madrid</creatorcontrib><creatorcontrib>Working group on Eosinophilic esophagitis of the “Gastrosuroeste group” in Madrid</creatorcontrib><title>Rising trend in p​ediatric eosinophilic esophagitis incidence in Spain: Results of a prospective study 2014–16</title><title>Pediatric allergy and immunology</title><addtitle>Pediatr Allergy Immunol</addtitle><description>Objectives The rate of eosinophilic esophagitis (EoE) diagnosis is increasing. This study aims to determine the incidence of EoE in the pediatric population residing in the southwestern Madrid and to analyze whether absolute monthly pollen counts, modified or not by the principal atmospheric pollutants, are associated with it. Methods A cross‐sectional study on prospectively recruited patients was designed to calculate the incidence of EoE in children aged under 15 years who were diagnosed between September 2014 and August 2016 in twelve hospitals. We collected demographic and symptoms data, date of onset of symptoms, date of medical consultation, and date of endoscopic diagnosis of each included patient. Relative risk estimation was performed to assess the association between the incidence of diagnosis and monthly pollen counts and levels of atmospheric pollutants. All these models were adjusted for the number of total patients that underwent endoscopy at first time. Results One hundred forty‐eight patients were included. The most frequent symptoms were abdominal pain [42.57%], dysphagia [42.57%], and impaction [39%–86%]. The median overall monthly incidence was 1.13 [interquartile rank: 0.97–1.43] cases/100,000 children, and the annual mean was 15.2. The overall analysis of the relationship between incidence and absolute monthly counts, corrected for the number of first‐time endoscopies performed, revealed no statistically significant association with pollen and air pollutants. There was a higher frequency of diagnosis during the pollination period of Cupressaceae [relative risk 1.647; 95% CI (1.192–2.276) p &lt; .002] and during February and November (relative risk 1.67; p &lt; .01). Conclusions This study confirms the high incidence of eosinophilic esophagitis and also suggests a period of higher incidence of diagnosis in the months of February and November as well as in the period of high pollination of Cupressaceae.</description><subject>Autoimmune diseases</subject><subject>Children</subject><subject>Cupressaceae</subject><subject>Diagnosis</subject><subject>Dysphagia</subject><subject>Endoscopy</subject><subject>eosinophilic esophagitis</subject><subject>epidemiology</subject><subject>Esophageal diseases</subject><subject>Esophagitis</subject><subject>Esophagus</subject><subject>Gastrointestinal diseases</subject><subject>Leukocytes (eosinophilic)</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Plant reproduction</subject><subject>Pollen</subject><subject>Pollination</subject><subject>Pollutants</subject><subject>Statistical analysis</subject><issn>0905-6157</issn><issn>1399-3038</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kUtP3DAQxy3UCpbHgS9QWeqlHAKejJ2Ne0OolJWQinico8QeL0bZJMRJq73tnWO_4X4SvF3KoVJ9GY_mN_95MXYM4hTiO-tKfwqo0nyHTQC1TlBg_oFNhBYqyUBN99h-CE9CwBQz2GV7iBqlBDlh_a0PvpnzoafGct_wbr16IevLofeGUxuDbffo640T4q-c-8GHCBpvqTG0SbmL9Zuv_JbCWA-Bt46XvOvb0JEZ_E_iYRjtkqcC5Hr1G7JD9tGVdaCjN3vAHi6_3V9cJdc_vs8uzq8TgwrzRKocjEsrAxYhcyTS3OWZRS3QKUXoANBoo7FSauqEtiBd5gBzqJzVUOEB-7LVjb08jxSGYuGDobouG2rHUKQqBamlyHREP_-DPrVj38TuIqUyLVIp00idbCkThws9uaLr_aLslwWIYnOIIi6i-HOIyH56UxyrBdl38u_mI3C2BX75mpb_VypuzmdbyVehSJLI</recordid><startdate>202108</startdate><enddate>202108</enddate><creator>La Orden Izquierdo, Enrique</creator><creator>Mahillo‐Fernández, Ignacio</creator><creator>Fernández Fernández, Sonia</creator><creator>Barrio Torres, Josefa</creator><creator>Román Riechmann, Enriqueta</creator><creator>Gutiérrez Junquera, Carolina</creator><creator>Santos, Alexandra</creator><creator>Cilleruelo Pascual, ML</creator><creator>Rayo Fernández, AI</creator><creator>Martínez Escribano, B</creator><creator>Botija Arcos, G</creator><creator>Barrio Merino, A</creator><creator>Urruzuno Tellería, P</creator><creator>Medina Benítez, E</creator><creator>Salcedo Lobato, E</creator><creator>Grande Herrero, L</creator><creator>Miranda Cid, C</creator><creator>Rodrigo García, G</creator><creator>Herrero Álvarez, M</creator><creator>Carabaño Aguado, I</creator><creator>Lancho Monreal, E</creator><creator>Romero Hombrebueno, N</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8686-2282</orcidid></search><sort><creationdate>202108</creationdate><title>Rising trend in p​ediatric eosinophilic esophagitis incidence in Spain: Results of a prospective study 2014–16</title><author>La Orden Izquierdo, Enrique ; Mahillo‐Fernández, Ignacio ; Fernández Fernández, Sonia ; Barrio Torres, Josefa ; Román Riechmann, Enriqueta ; Gutiérrez Junquera, Carolina ; Santos, Alexandra ; Cilleruelo Pascual, ML ; Rayo Fernández, AI ; Martínez Escribano, B ; Botija Arcos, G ; Barrio Merino, A ; Urruzuno Tellería, P ; Medina Benítez, E ; Salcedo Lobato, E ; Grande Herrero, L ; Miranda Cid, C ; Rodrigo García, G ; Herrero Álvarez, M ; Carabaño Aguado, I ; Lancho Monreal, E ; Romero Hombrebueno, N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-4581cf2bc1d316fe028f86d3903f55e3f113c9c93b557f09d14f6f1381bfd91b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Autoimmune diseases</topic><topic>Children</topic><topic>Cupressaceae</topic><topic>Diagnosis</topic><topic>Dysphagia</topic><topic>Endoscopy</topic><topic>eosinophilic esophagitis</topic><topic>epidemiology</topic><topic>Esophageal diseases</topic><topic>Esophagitis</topic><topic>Esophagus</topic><topic>Gastrointestinal diseases</topic><topic>Leukocytes (eosinophilic)</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Plant reproduction</topic><topic>Pollen</topic><topic>Pollination</topic><topic>Pollutants</topic><topic>Statistical analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>La Orden Izquierdo, Enrique</creatorcontrib><creatorcontrib>Mahillo‐Fernández, Ignacio</creatorcontrib><creatorcontrib>Fernández Fernández, Sonia</creatorcontrib><creatorcontrib>Barrio Torres, Josefa</creatorcontrib><creatorcontrib>Román Riechmann, Enriqueta</creatorcontrib><creatorcontrib>Gutiérrez Junquera, Carolina</creatorcontrib><creatorcontrib>Santos, Alexandra</creatorcontrib><creatorcontrib>Cilleruelo Pascual, ML</creatorcontrib><creatorcontrib>Rayo Fernández, AI</creatorcontrib><creatorcontrib>Martínez Escribano, B</creatorcontrib><creatorcontrib>Botija Arcos, G</creatorcontrib><creatorcontrib>Barrio Merino, A</creatorcontrib><creatorcontrib>Urruzuno Tellería, P</creatorcontrib><creatorcontrib>Medina Benítez, E</creatorcontrib><creatorcontrib>Salcedo Lobato, E</creatorcontrib><creatorcontrib>Grande Herrero, L</creatorcontrib><creatorcontrib>Miranda Cid, C</creatorcontrib><creatorcontrib>Rodrigo García, G</creatorcontrib><creatorcontrib>Herrero Álvarez, M</creatorcontrib><creatorcontrib>Carabaño Aguado, I</creatorcontrib><creatorcontrib>Lancho Monreal, E</creatorcontrib><creatorcontrib>Romero Hombrebueno, N</creatorcontrib><creatorcontrib>Working group on Eosinophilic esophagitis of the “Gastrosuroeste group” in Madrid</creatorcontrib><creatorcontrib>Working group on Eosinophilic esophagitis of the “Gastrosuroeste group” in Madrid</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; 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This study aims to determine the incidence of EoE in the pediatric population residing in the southwestern Madrid and to analyze whether absolute monthly pollen counts, modified or not by the principal atmospheric pollutants, are associated with it. Methods A cross‐sectional study on prospectively recruited patients was designed to calculate the incidence of EoE in children aged under 15 years who were diagnosed between September 2014 and August 2016 in twelve hospitals. We collected demographic and symptoms data, date of onset of symptoms, date of medical consultation, and date of endoscopic diagnosis of each included patient. Relative risk estimation was performed to assess the association between the incidence of diagnosis and monthly pollen counts and levels of atmospheric pollutants. All these models were adjusted for the number of total patients that underwent endoscopy at first time. Results One hundred forty‐eight patients were included. The most frequent symptoms were abdominal pain [42.57%], dysphagia [42.57%], and impaction [39%–86%]. The median overall monthly incidence was 1.13 [interquartile rank: 0.97–1.43] cases/100,000 children, and the annual mean was 15.2. The overall analysis of the relationship between incidence and absolute monthly counts, corrected for the number of first‐time endoscopies performed, revealed no statistically significant association with pollen and air pollutants. There was a higher frequency of diagnosis during the pollination period of Cupressaceae [relative risk 1.647; 95% CI (1.192–2.276) p &lt; .002] and during February and November (relative risk 1.67; p &lt; .01). Conclusions This study confirms the high incidence of eosinophilic esophagitis and also suggests a period of higher incidence of diagnosis in the months of February and November as well as in the period of high pollination of Cupressaceae.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33934414</pmid><doi>10.1111/pai.13528</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8686-2282</orcidid></addata></record>
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subjects Autoimmune diseases
Children
Cupressaceae
Diagnosis
Dysphagia
Endoscopy
eosinophilic esophagitis
epidemiology
Esophageal diseases
Esophagitis
Esophagus
Gastrointestinal diseases
Leukocytes (eosinophilic)
Patients
Pediatrics
Plant reproduction
Pollen
Pollination
Pollutants
Statistical analysis
title Rising trend in p​ediatric eosinophilic esophagitis incidence in Spain: Results of a prospective study 2014–16
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