Original articlePredictors of Response to Proton Pump Inhibitor Therapy among Children with Significant Esophageal Eosinophilia
Section snippets
Methods
All patients between the ages of 1 and 18 years who underwent esophagogastroduodenoscopy (EGD) between 1999 and 2006 by the Division of Pediatric Gastroenterology, Hepatology, and Nutrition at the James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, and demonstrated SEE (defined as ≥15 eos/hpf on distal and/or mid-esophageal biopsy) were identified. The indications for EGD included regurgitation, vomiting, heartburn, abdominal pain,
Patients with SEE
A total of 326 patients between ages 1 and 18 years were diagnosed with SEE during the study period. Of these, 43 patients (mean age, 8.5 years; median age, 10 years; 67% males) met the study inclusion criteria, with the oldest child age 17 years. After PPI therapy, 17 of the 43 patients (40%) were responders and 26 patients (60%) were nonresponders (Table I). There were no significant differences in the demographics or presenting symptoms between responders and nonresponders. The vast majority
Discussion
Our study examines the response to PPI therapy in a large cohort of children with SEE. The use of PPI as initial therapy for SEE has recently resurfaced on the basis of the report by Ngo et al15 of 3 patients with SEE who responded symptomatically and histologically to PPI therapy. This, coupled with the recent recommendation from the First International Gastrointestinal Eosinophil Research Symposium17 to treat SEE with a PPI in lieu of a pH study, prompted a review of our experience in
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The authors declare no conflicts of interest or grant support.