Eosinophilic esophagitis in Colombian children: relationship between food allergens, symptoms and endoscopic findings

BACKGROUND: Eosinophilic esophagitis (EoE) is an immune-mediated disease characterised by oesophageal eosinophilic infiltration, leading to chronic inflammation and tissue remodelling. OBJECTIVES: To describe the clinical, epidemiological and endoscopic characteristics of children with EoE in Colombia, and explore associations between symptoms, allergen sensitisation and endoscopic findings. METHODS: Observational, multicentre retrospective study with an analytical component, conducted on paediatric patients diagnosed with EoE across 10 tertiary referral centres in Colombia between 2015 and 2023. All cases had histological confirmation with ≥15 eosinophils per high-power field. Data were extracted from standardised medical records by trained investigators. RESULTS: A total of 143 cases were included, with a male predominance (66.4%) and median age at diagnosis of 92 months (IQR 56-144). Relevant early exposures included prematurity (11.2%), low birth weight (10.5%), caesarean delivery (50.3%), infant formula use (62.2%) and antibiotics in infancy (27.9%). Family history of atopy was present in 54.6%, and EoE in 4.9%. Food specific IgE was present, particularly to cow's milk (56.6%) and egg (38.1%). Most frequent symptoms included abdominal pain (67.1%), nausea (60.1%) and vomiting (46.2%). Endoscopic findings included longitudinal furrows (70.9%) and white exudates (67.4%). Statistically significant associations were found between dysphagia and oesophageal rings (p=0.003), vomiting and white exudates (p=0.018), abdominal pain and longitudinal furrows (p=0.025) and regurgitation and oedema (p=0.031). CONCLUSIONS: Paediatric EoE in Colombia shows symptom and endoscopic heterogeneity. Identifying potential allergen triggers may contribute to understanding symptoms and endoscopic patterns in EoE.