Increasing Age at the Time of Diagnosis and Evolving Phenotypes of Eosinophilic Esophagitis Over 20 Years

• Published in: Digestive diseases and sciences 2024-02, Vol.69 (2), p.521-527
• Main Authors: Kiran, Akshatha, Cameron, Brenderia A., Xue, Zeyun, LaFata, Sean, Ocampo, Adolfo A., McCallen, Justin, Lee, Christopher J., Borinsky, Stephanie A., Redd, Walker D., Cotton, Cary C., Eluri, Swathi, Reed, Craig C., Dellon, Evan S.
• Format: Article
• Language: English
• Subjects: Adult; Age; Biochemistry; Child; Connective tissue diseases; Connective Tissue Diseases - complications; Deglutition Disorders - etiology; Dysphagia; Endoscopy; Enteritis; Eosinophilia; Eosinophilic Esophagitis - complications; Eosinophilic Esophagitis - diagnosis; Eosinophilic Esophagitis - epidemiology; Gastritis; Gastroenterology; Hepatology; Humans; Medicine; Medicine & Public Health; Multivariate analysis; Oncology; Original Article; Phenotype; Retrospective Studies; Transplant Surgery; Trends; Young Adult
• ISSN: 0163-2116; 1573-2568; 1573-2568
• DOI: 10.1007/s10620-023-08165-z

Background The presentation of eosinophilic esophagitis (EoE) is heterogeneous, but trends over time are not known. Aim To determine whether clinical and endoscopic phenotypes at EoE diagnosis have changed over the past 2 decades. Methods In this retrospective cohort study, adults and children with newly diagnosed EoE were phenotyped as follows: (1) inflammatory vs fibrostenotic vs mixed on endoscopy; (2) atopic vs non-atopic; (3) age at symptom onset; (4) age at diagnosis; (5) presence of autoimmune or connective tissue disease; and (6) responsive to steroids. The prevalence of different phenotypes was categorized by 5-year intervals. Multivariate analysis was performed to assess for changes in patient features over time. Results Of 1187 EoE patients, age at diagnosis increased over time (from 22.0 years in 2002–2006 to 31.8 years in 2017–2021; p