The Association between Celiac Disease and Eosinophilic Esophagitis among Children, in Isfahan, Iran

Background: The prevalence of eosinophilic esophagitis (EoE) has increased in recent decades. Recent studies have found that the prevalence of EoE in patients with celiac disease (CD) is much higher compared with the general population. In this study, the prevalence of EoE in children with CD was calculated and their clinical symptoms, endoscopic and histopathological findings were compared. Methods: This was a retrospective study conducted on the data records of the patients diagnosed with celiac disease during 2012-2020, and registered at Imam Hossein Children's Hospital and the Institute of the Celiac Association in Isfahan, Iran. Clinical findings, endoscopic reports, serological and histopathological data of the patients were recorded and analyzed. Results: A total of 80 children with CD were included in the study. The mean age of the patients with CD and EoE (n=8) was 7.75 +/- 3.99 years, and in children with CD alone (n=72), the mean age was 7.85 +/- 3.83. The most common clinical findings were abdominal pain, anorexia, diarrhea and constipation. There were no significant differences in the symptoms of either group. The most common endoscopic view was duodenal scalloping and esophagitis; and 50% of EoE patients had a normal endoscopic view of the esophagus. With regards to serological fmdings, the level of TTG-IgA (U/ml) in the CD and EoE group was higher than the CD group (183.73 +/- 101.54 vs. 117.07 +/- 95.34 U/ml); however, no statistically significant difference was observed. Conclusion: Our study found that the prevalence of EoE in children with CD appears to be higher than in previous studies. We have also shown that the presence of EoE cannot be detected solely based on clinical and even endoscopic results. Therefore. an esophageal biopsy is recommended in celiac patients.