RISK OF DEVELOPING EOSINOPHILIC ESOPHAGITIS WITH PREEXISTING ASTHMA, ALLERGIC RHINITIS, ATOPIC DERMATITIS, OR FOOD ALLERGY

Introduction

Eosinophilic esophagitis (EoE) is a chronic antigen-mediated disorder of the esophagus leading to esophageal dysfunction that is frequently seen in atopic patients. We investigated the probability of various atopic conditions developing EoE.

Methods

This retrospective cohort study utilized TriNetX US Collaborative Network to identify pediatric patients ages 1-18 years with a diagnosis of asthma, allergic rhinitis, atopic dermatitis, or food allergies from 2016 to 2018. Separate analyses were run for each diagnosis. The control population consisted of patients without the atopy diagnosis who had any documented ICD-10 diagnosis. The cohorts were matched for age at index, sex, race, ethnicity, and the other atopic conditions. The three-year hazard ratio (HR) of developing EoE relative to the controls was calculated.

Results

For the asthma group, there were 1,885 patients that developed EoE versus 726 in the control group (HR 2.35; 95% CI 2.16 – 2.56; p-value <0.001). For the allergic rhinitis group, there were 1,444 patients that developed EoE versus 829 in the control group (HR 1.45; 95% CI 1.34 - 1.58; p-value <0.001). For atopic dermatitis, there were 533 patients that developed EoE versus 307 patients in the control group (HR 1.53; 95% CI 1.33 - 1.76; p-value <0.001). For patients with food allergies, there were 1,098 patients that subsequently developed EoE versus 166 in the control group (HR 6.31; 95% CI 5.36 - 7.43; p-value <0.001).

Conclusion

All atopic risk factors studied were associated with an increased risk of developing EoE. Food allergy had the highest risk of developing EoE.