1 - ENT department, CHULC, Lisbon, Portugal
2 - ENT Department, CHULC / Hospital de Cascais Dr. José de Almeida, Portugal
3 - Immunoallergology Department, CHULC, Lisbon, Portugal
- Reunião Nacional - 71º Congreso Nacional SEORL-CCC sob a forma de comunicação oral;
- Publicado sob a forma de artigo integral original na Revista Portuguesa de Otorrinolaringologia e Crirugia de Cabeça e Pescoço - Órgão Oficial da Sociedade Portuguesa de Otorrinolaringologia e Cirurgia e Cabeça e Pescoço VOL. 58 . No 4 . DEZEMBRO 2020 ; Págs 205-211
Resumo:
Introduction: Eosinophilic esophagitis (EoE) is strongly associated with atopy and studies suggest that 47 to 84% of children with EoE have allergic rhinitis. To date, there are no studies showing if the frequency of these symptoms is superior in children with EoE than in other children. The aim of this study is to understand if children with EoE have more ENT symptoms than children only with allergic rhinitis.
Material and Methods: Case control study adjusted for sex, age and control of rhinitis symptoms. The study was conducted from January 2019 to January 2020 in a tertiary paediatric hospital. The study group included children diagnosed with EoE and the control group consisted of children with allergic rhinitis. An ENT observation protocol was used to evaluate every children, who answered to a complete questionary and, in selected cases, tympanogram and nasal endoscopy were also performed. The CARAT kids questionnaire was used to evaluate the level of control of children’s rhinitis. This study was approved by the local research ethics committee.
Results: This study included 45 children. The study group consisted of 15 children diagnosed with EoE (6 with allergic rhinitis and 9 with non-allergic rhinitis) and the control group consisted of 30 cases with allergic rhinitis. Both groups included children who were 6 to 17 years old. There were no statistically significant differences between the two groups concerning sex (p>0,05), age (p>0,05) or CARAT kids score for questions for upper respiratory tract (p>0,05) and for low respiratory tract (p>0,05). There was also no statistically significant difference regarding the cases of asthma between case and control groups (p>0,05). In the case group, 9 children were taking nasal corticoids and 4 of them were also taking swallowed corticoids. There was only one child in the case group taking exclusively inhaled corticoids. In the control group, 24 children were being treated with nasal corticoids and 5 of them were also taking inhaled corticoids. There were two children in the control group being treated just with inhaled corticoids. When ENT symptoms were analysed separately there were no statistically significant differences between case and control groups (p>0,05). There was also no statistically significant difference between the number of symptoms (p>0,05). ENT surgeries in the past were similar in both groups (p>0,05).
Discussion and Conclusions: Even though several studies demonstrated an association between EoE and ENT symptoms, this study shows they are not more common in children with EoE than in children with allergic rhinitis. An important limitation of this study is the existence of children with different EoE activity levels in the case group and the fact that they were already treated with drugs or diet. Another limitation of this study is the lack of quantification of corticoid doses prescribed to patients of both groups. Future larger studies are needed to confirm our findings.
Palavras Chave: Eosinophilic esophagitis, Otolaryngology, allergic rhinitis, child